NPIMap

Organization Active NPI

Orthopedic Rehab Specialists of Dixon, LLC

  • Physical Therapist
  • Dixon, IL
National Provider Identifier
1679778435
Registry record updated Jan 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
ORTHOPEDIC REHAB SPECIALISTS OF DIXON, LLC
Practice address
201 Lincoln Statue Dr
Dixon, IL 61021-2000
Phone
(815) 284-1700
Fax
(815) 284-1704
NPI assigned
Jun 20, 2007
Last updated
Jan 8, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2013

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

Authorized official

Name
Gordon K Green, PT, OMTNPI 1649281452
Title
President
Phone
(815) 227-1700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

201 Lincoln Statue Dr
Dixon, IL 61021-2000

Mailing address

2662 McFarland Rd
Rockford, IL 61107-6806
Phone (815) 284-1700

National Provider Directory

National Provider Directory

Locations

201 Lincoln Statue Dr
Ste 102
Dixon, IL 61021
Phone (815) 284-1700

2662 McFarland Rd
Rockford, IL 61107
Phone (815) 226-8780

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1182297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357603200000",
    "number": "1679778435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2662 MCFARLAND RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611076806",
            "telephone_number": "815-284-1700",
            "fax_number": "815-284-1704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 LINCOLN STATUE DR",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "610212000",
            "telephone_number": "815-284-1700",
            "fax_number": "815-284-1704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOPEDIC REHAB SPECIALISTS OF DIXON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-20",
        "last_updated": "2013-01-08",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "GORDON",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-227-1700",
        "authorized_official_credential": "PT, OMT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dixon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2013; 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.