Powerback Rehabilitation LLC

Primary specialty

Rehabilitation Clinic/CenterTaxonomy code 261QR0400X

Legal business name

POWERBACK REHABILITATION LLC

Doing business as

Genesis Rehabilitation Services

Practice address

319 E Dunstable Rd
Nashua, NH 03062-4207

Phone

(603) 888-7878

NPI assigned

Dec 23, 2005

Last updated

Mar 1, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Carl Anthony Shrom

Title

Ceo

Phone

(215) 896-0422

Specialties & licenses 4

Addresses

Other names 1

• Genesis Rehabilitation Services Doing business as

Medicare fee-for-service enrollment

Enrolled in NH

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1659358281. Details of each certification follow.

• CCN 306519 Outpatient physical therapy / speech pathology · Active · Name & address match · Details

Outpatient physical therapy / speech pathology certification: CCN 306519

Legal name

GENESIS REHABILITATION SERVICES

Certification status

Active

Provider type (POS)

Outpatient physical therapy / speech pathology

Participating since

Oct 30, 2002

Last certification

Feb 3, 2022

Ownership / control type

Proprietary

Facility address

319 E Dunstable Road
Nashua, NH 03062

Tax ID family

Genesis Eldercare Rehab LLC209 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 10

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

• Genesis Eldercare Rehab Srvcs

  • Occupational Therapist
  • Bedford, NH
  • NPI 1245358571
  NPD tax ID
• Genesis Eldercare Rehab SVCS

  • Skilled Nursing Facility
  • Manchester, NH
  • NPI 1932337110
  NPD tax ID
• Genesis Healthcare

  • Occupational Therapist
  • Keene, NH
  • NPI 1831477686
  NPD tax ID
• Genesis Rehab Services

  • Rehabilitation Clinic/Center
  • Lancaster, NH
  • NPI 1285069203
  NPD tax ID
• Genesis Rehab Services

  • Skilled Nursing Facility
  • Ossipee, NH
  • NPI 1285069369
  NPD tax ID
• Genesis Rehab Services

  • Skilled Nursing Facility
  • Manchester, NH
  • NPI 1386981181
  NPD tax ID
• Genesis Rehab Services

  • Physical Therapy Clinic/Center
  • Lancaster, NH
  • NPI 1629361175
  NPD tax ID
• Genesis Rehabilitation Services

  • Skilled Nursing Facility
  • Laconia, NH
  • NPI 1104949825
  NPD tax ID
• Genesis Rehabilitation Services

  • Skilled Nursing Facility
  • Tilton, NH
  • NPI 1467575183
  NPD tax ID
• Genesis Rehabilitation Services

  • Physical Therapist
  • Berlin, NH
  • NPI 1619317930
  NPD tax ID

All facility ownership & control disclosures 25

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

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

{
    "created_epoch": "1135296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677628800000",
    "number": "1659358281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E STATE ST",
            "address_2": "C/O AMY NUNEMAKER",
            "city": "KENNETT SQUARE",
            "state": "PA",
            "postal_code": "193483109",
            "telephone_number": "800-728-8808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 E DUNSTABLE RD",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030624207",
            "telephone_number": "603-888-7878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POWERBACK REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-23",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A",
        "authorized_official_last_name": "SHROM",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "215-896-0422"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Genesis Rehabilitation Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Caitlin Potter
• Fredrick C Potter, R.PH.
• Mertie Lorraine Potter, DNP, ARNP, BC
• Brianna Lisa Poulin
• Casey M Poulios, APRN
• Mackenzie Powers
• Anil Prasad, MD
• Ryan J Pratt, D.C.
• Sandra Pratt, BS, M.ED
• Premier Medical Staffing, Inc.

• Rehabilitation Clinic/Center in Nashua, NH
• Providers in Nashua, NH by specialty
• Rehabilitation Clinic/Center in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.