NPIMap

Organization Active NPI

Perry County Rehab & Diagnostic Center

  • Clinic/Center
  • Somerset, OH
National Provider Identifier
1629136437
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
PERRY COUNTY REHAB & DIAGNOSTIC CENTER
Practice address
301 Dr Mike Clouse Drive
Somerset, OH 43783
Phone
(740) 743-3800
Fax
(740) 743-3900
NPI assigned
Dec 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Anthony Edward Kordack
Title
Executive Director
Phone
(740) 687-0036

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

301 Dr Mike Clouse Drive
Somerset, OH 43783

Mailing address

2405 N Columbus St
Suite 140
Lancaster, OH 43130-8185
Phone (740) 743-3800

Other identifiers 1

IdentifierTypeStateIssuer
2278440MedicaidOH

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1629136437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2405 N COLUMBUS ST",
            "address_2": "SUITE 140",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431308185",
            "telephone_number": "740-743-3800",
            "fax_number": "740-743-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 DR MIKE CLOUSE DRIVE",
            "city": "SOMERSET",
            "state": "OH",
            "postal_code": "43783",
            "telephone_number": "740-743-3800",
            "fax_number": "740-743-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERRY COUNTY REHAB & DIAGNOSTIC CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KORDACK",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "740-687-0036",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2278440",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerset, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.