NPIMap

Organization Active NPI

Empowerme Rehabilitation, LLC

  • Rehabilitation Clinic/Center
  • Clarkston, MI
National Provider Identifier
1659943314
Registry record updated Dec 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
EMPOWERME REHABILITATION, LLC
Practice address
5700 Water Tower PL
Clarkston, MI 48346-2668
Phone
(844) 502-7996
NPI assigned
Jul 13, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2023

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

Authorized official

Name
John David Church
Title
Vice President of Finance
Phone
(618) 972-5228

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X Primary

Addresses

Primary practice location

5700 Water Tower PL
Clarkston, MI 48346-2668

Mailing address

PO Box 736005
Dallas, TX 75373-6005
Phone (844) 502-7996

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service Other eSolutions Inc.

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210811000249 MI Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 2769723162 Practice locations: Clarkston, MI

Other NPIs with the same Medicare PAC ID 15

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 15

National Provider Directory

National Provider Directory
Tax ID family
Empowerme Rehabilitation LLC35 organizations share this tax ID, including this one

Other organizations with this tax ID 34

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

View all 34

Practitioners & affiliated clinicians

Practitioners 423

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

View all 423

NPI Registry JSON

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

{
    "created_epoch": "1626134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702684800000",
    "number": "1659943314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 736005",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753736005",
            "telephone_number": "844-502-7996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 WATER TOWER PL",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483462668",
            "telephone_number": "844-502-7996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMPOWERME REHABILITATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-13",
        "last_updated": "2023-12-16",
        "certification_date": "2023-12-16",
        "status": "A",
        "authorized_official_last_name": "CHURCH",
        "authorized_official_first_name": "JOHN DAVID",
        "authorized_official_title_or_position": "VICE PRESIDENT OF FINANCE",
        "authorized_official_telephone_number": "618-972-5228"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1066.1",
            "affiliationName": "eSolutions Inc.",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CSV",
            "address_1": "8215 W 108th Ter",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Clarkston, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2023; 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.