Midwest Sport & Spine Rehabilitation LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

05008884A Issued in IN

Legal business name

MIDWEST SPORT & SPINE REHABILITATION LLC

Practice address

4420 W Jonathan Moore Pike
Columbus, IN 47201-4685

Phone

(812) 342-2411

Fax

(812) 342-2413

NPI assigned

Apr 26, 2010

Organization subpart

No

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

Authorized official

Name

Duke Wade Hartwell, PT, CERT MDT

Title

Owner

Phone

(812) 342-2411

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michelle D Sharp, OT

  • Occupational Therapist
  • Columbus, IN
  • NPI 1568615433
  NPD (past)

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

{
    "created_epoch": "1272240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280966400000",
    "number": "1609193911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4420 W JONATHAN MOORE PIKE",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472014685",
            "telephone_number": "812-342-2411",
            "fax_number": "812-342-2413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4420 W JONATHAN MOORE PIKE",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472014685",
            "telephone_number": "812-342-2411",
            "fax_number": "812-342-2413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST SPORT & SPINE REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-26",
        "last_updated": "2010-08-05",
        "status": "A",
        "authorized_official_last_name": "HARTWELL",
        "authorized_official_first_name": "DUKE",
        "authorized_official_middle_name": "WADE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "812-342-2411",
        "authorized_official_credential": "PT, CERT MDT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "IN",
            "license": "05008884A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael D. Mangas, O.D., P.C.
• Kimberly Middleton
• Robert Brennon Middleton, DPM
• Midwest Eye Consultants, P.C.
• Midwest Eye Consultants, P.C.
• Richard Miethke, MD
• Emily Rose Miklusak, AU.D.
• Mill Race Center, Inc.
• Maricella Millan, RBT
• Alexander Miller

• Physical Therapy Clinic/Center in Columbus, IN
• Providers in Columbus, IN by specialty
• Physical Therapy Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2010; 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.