NPIMap

Organization Active NPI

Rehabcare Group East, LLC

  • Rehabilitation Clinic/Center
  • Plymouth, MN
National Provider Identifier
1669425823
Registry record updated Apr 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
REHABCARE GROUP EAST, LLC
Practice address
3390 Annapolis LN N Ste B
Plymouth, MN 55447-5379
Phone
(763) 767-0854
Fax
(763) 862-6533
NPI assigned
May 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2019

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

Authorized official

Name
Mr. Terrance K. Dillon
Title
Assistant Secretary
Phone
(502) 596-7220

Specialties & licenses 1

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

Addresses

Primary practice location

3390 Annapolis LN N Ste B
Plymouth, MN 55447-5379

Mailing address

3390 Annapolis LN N Ste B
Plymouth, MN 55447-5379
Phone (763) 767-0854

Other identifiers 1

IdentifierTypeStateIssuer
545755600MedicaidMN

Other names 1

  • RehabCare Doing business as

National Provider Directory

National Provider Directory

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Locations

7600 Boone Ave N
Ste 2
Brooklyn Park, MN 55428
Phone (763) 515-2441

300 Coon Rapids Blvd NW
Ste 200
Coon Rapids, MN 55433
Phone (763) 767-0854

260 Magnus Johnson St N
Kimball, MN 55353
Phone (320) 398-8646

3390 Annapolis Ln N
Ste B
Plymouth, MN 55447
Phone (320) 305-4121

3300 Fernbrook Ln N
Plymouth, MN 55447
Phone (763) 559-7050

Practitioners & affiliated clinicians

Practitioners 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556582400000",
    "number": "1669425823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3390 ANNAPOLIS LN N STE B",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554475379",
            "telephone_number": "763-767-0854",
            "fax_number": "763-862-6533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3390 ANNAPOLIS LN N STE B",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554475379",
            "telephone_number": "763-767-0854",
            "fax_number": "763-862-6533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REHABCARE GROUP EAST, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2019-04-30",
        "status": "A",
        "authorized_official_last_name": "DILLON",
        "authorized_official_first_name": "TERRANCE",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "502-596-7220",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "545755600",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RehabCare",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "RehabCare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Plymouth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2019; 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.