NPIMap

Organization Active NPI

St Charles Rehabilitation

  • Rehabilitation Hospital
  • Patchogue, NY
National Provider Identifier
1649677964
Registry record updated Dec 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation HospitalTaxonomy code 283X00000X
License
038336 Issued in NY
Legal business name
ST CHARLES REHABILITATION
Practice address
77 Route 112 Ste F
Patchogue, NY 11772-1230
Phone
(631) 207-2370
Fax
(631) 758-1748
NPI assigned
Dec 2, 2014
Last updated
Dec 2, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2014

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

Authorized official

Name
Mr. Brendon Howard Nolan, DPTNPI 1376000547
Title
Physical Therapist
Phone
(631) 312-2834

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital 283X00000X 038336 NY Primary

Addresses

Primary practice location

77 Route 112 Ste F
Patchogue, NY 11772-1230

Mailing address

77 Route 112 Ste F
Patchogue, NY 11772-1230

National Provider Directory

National Provider Directory
Tax ID family
St Charles Hosp-Echocardi9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

77 Route 112
Ste F
Patchogue, NY 11772
Phone (631) 207-2370

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1417478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417478400000",
    "number": "1649677964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 ROUTE 112 STE F",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117721230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 ROUTE 112 STE F",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117721230",
            "telephone_number": "631-207-2370",
            "fax_number": "631-758-1748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST CHARLES REHABILITATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-02",
        "last_updated": "2014-12-02",
        "status": "A",
        "authorized_official_last_name": "NOLAN",
        "authorized_official_first_name": "BRENDON",
        "authorized_official_middle_name": "HOWARD",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "631-312-2834",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "283X00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Hospital",
            "state": "NY",
            "license": "038336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Patchogue, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2014; 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.