Organization Active NPI

Premier Care Rehabilitation

  • Internal Medicine Physician
  • Detroit, MI
National Provider Identifier
1700304912
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
PREMIER CARE REHABILITATION
Practice address
10641 W McNichols Rd
Detroit, MI 48221-2303
Phone
(313) 574-8205
NPI assigned
Sep 7, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Corina MaloneNPI 1578949822
Title
Owner
Phone
(313) 574-8205

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

10641 W McNichols Rd
Detroit, MI 48221-2303

Mailing address

10641 W McNichols Rd
Detroit, MI 48221-2303
Phone (313) 574-8205

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180419001199 MI Part B Supplier - Physical/Occupational Therapy Group in Private Practice 4981967254 Receives reassigned benefits from 1 practitioner
Practice locations: Detroit, MI

National Provider Directory

National Provider Directory

Locations

10641 W McNichols Rd
Detroit, MI 48221
Phone (313) 340-9944

Practitioners & affiliated clinicians

Practitioners 2

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": "1504742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1700304912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10641 W MCNICHOLS RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482212303",
            "telephone_number": "313-574-8205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10641 W MCNICHOLS RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482212303",
            "telephone_number": "313-574-8205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER CARE REHABILITATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-07",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "MALONE",
        "authorized_official_first_name": "CORINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-574-8205"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.