Promedical Rehab Group Inc

Primary specialty

SpecialistTaxonomy code 174400000X

License

35060023 Issued in OH

Legal business name

PROMEDICAL REHAB GROUP INC

Practice address

1611 27TH St
BLDG. J. Suite202
Portsmouth, OH 45662-6931

Phone

(740) 354-3344

Fax

(740) 353-0585

NPI assigned

Oct 24, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Terrence B Welsh, M.D.

Title

President

Phone

(740) 354-3344

Specialties & licenses 1

Addresses

Other identifiers 4

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259798400000",
    "number": "1528141132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 27TH ST",
            "address_2": "BLDG. J. SUITE202",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456626931",
            "telephone_number": "740-354-3344",
            "fax_number": "740-353-0585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 27TH ST",
            "address_2": "BLDG. J. SUITE202",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456626931",
            "telephone_number": "740-354-3344",
            "fax_number": "740-353-0585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROMEDICAL REHAB GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2009-12-03",
        "status": "A",
        "authorized_official_last_name": "WELSH",
        "authorized_official_first_name": "TERRENCE",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "740-354-3344",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "OH",
            "license": "35060023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64869563",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0246755",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2492985",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000039284",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sunnie Price, CDCA
• Primary Medical Specialists, Inc
• Prime Pharmacy Inc (Medi Mart Pharmacy)
• Pristine Senior Living of Portsmouth, LLC
• Mary Pritchard, RPH
• Alexander Craig Provaznik
• Jaime M Pua, MD
• Abigail Puckett, CDCA
• April Dawn Puckett
• Bo Puckett

• Specialist in Portsmouth, OH
• Providers in Portsmouth, OH by specialty
• Specialist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.