NPIMap

Organization Active NPI

Mobility Rehabilitation Specialist

  • Physical Therapist
  • Maumee, OH
National Provider Identifier
1679623946
Registry record updated Oct 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
MOBILITY REHABILITATION SPECIALIST
Practice address
3039 Plumbrook Dr
Maumee, OH 43537-9662
Phone
(419) 361-9037
Fax
(419) 474-2505
NPI assigned
Jan 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2007

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

Authorized official

Name
Jackie Heller
Title
Manager
Phone
(513) 232-1924

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

3039 Plumbrook Dr
Maumee, OH 43537-9662

Mailing address

3039 Plumbrook Dr
Maumee, OH 43537-9662
Phone (419) 361-9037

Other identifiers 1

IdentifierTypeStateIssuer
2423854MedicaidOH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 10

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": "1168473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193702400000",
    "number": "1679623946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3039 PLUMBROOK DR",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435379662",
            "telephone_number": "419-361-9037",
            "fax_number": "419-474-2505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3039 PLUMBROOK DR",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435379662",
            "telephone_number": "419-361-9037",
            "fax_number": "419-474-2505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILITY REHABILITATION SPECIALIST",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-11",
        "last_updated": "2007-10-30",
        "status": "A",
        "authorized_official_last_name": "HELLER",
        "authorized_official_first_name": "JACKIE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "513-232-1924"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2423854",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maumee, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2007; 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.