NPIMap

Organization Active NPI

Rehab Connection Inc

  • Physical Therapist
  • Riverview, MI
National Provider Identifier
1659446359
Registry record updated Aug 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501010391 Issued in MI
Legal business name
REHAB CONNECTION INC
Practice address
13638 Sibley Rd
Riverview, MI 48193-7406
Phone
(734) 288-3739
Fax
(734) 288-3745
NPI assigned
Nov 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2014

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

Authorized official

Name
Dr. Michael T PrudhommeNPI 1548564255
Title
Owner
Phone
(734) 288-3739

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X 5501010391 MI Primary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X 5501012030 MI

Addresses

Primary practice location

13638 Sibley Rd
Riverview, MI 48193-7406

Mailing address

13638 Sibley Rd
Riverview, MI 48193-7406
Phone (734) 288-3739

Other names 1

  • Healthcore Physical Therapy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140808001432 MI Part B Supplier - Physical/Occupational Therapy Group in Private Practice 1557309739 Receives reassigned benefits from 3 practitioners
Practice locations: Brownstown TWP, MI; Riverview, MI

National Provider Directory

National Provider Directory

Locations

20769 Gibraltar Rd
Brownstown Twp, MI 48183
Phone (734) 301-3402

13638 Sibley Rd
Riverview, MI 48193
Phone (734) 288-3739

Practitioners & affiliated clinicians

Practitioners 9

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

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409184000000",
    "number": "1659446359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13638 SIBLEY RD",
            "city": "RIVERVIEW",
            "state": "MI",
            "postal_code": "481937406",
            "telephone_number": "734-288-3739",
            "fax_number": "734-288-3745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13638 SIBLEY RD",
            "city": "RIVERVIEW",
            "state": "MI",
            "postal_code": "481937406",
            "telephone_number": "734-288-3739",
            "fax_number": "734-288-3745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REHAB CONNECTION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-21",
        "last_updated": "2014-08-28",
        "status": "A",
        "authorized_official_last_name": "PRUDHOMME",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "734-288-3739",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501010391",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501012030",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Healthcore Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Riverview, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.