NPIMap

Organization Active NPI

Physicians Diagnostic & Rehabilitation Center of Warren in

  • Physical Medicine & Rehabilitation Physician
  • Warren, OH
National Provider Identifier
1700987229
Registry record updated Nov 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
34.002093 Issued in OH
Legal business name
PHYSICIANS DIAGNOSTIC & REHABILITATION CENTER OF WARREN IN
Practice address
2048 N River Rd NE # 3
Warren, OH 44483-2530
Phone
(330) 372-5550
Fax
(330) 372-5551
NPI assigned
Sep 26, 2006
Last updated
Nov 19, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2012

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

Authorized official

Name
Dr. Keith P Farrell, D.C.NPI 1679590541
Title
Owner
Phone
(330) 372-5550

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NR0200X 3569 OH
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X 34.002093 OH Primary

Addresses

Primary practice location

2048 N River Rd NE # 3
Warren, OH 44483-2530

Mailing address

PO Box 14465
Poland, OH 44514-7465
Phone (330) 372-5550

National Provider Directory

National Provider Directory

Locations

2048 N River Rd NE
Warren, OH 44483
Phone (330) 372-5550

2048 N River Rd NE
#3
Warren, OH 44483
Phone (330) 372-5550

2048 N River Rd NE
Ste 3
Warren, OH 44483
Phone (330) 372-5550

Practitioners & affiliated clinicians

Practitioners 5

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": "1159228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353283200000",
    "number": "1700987229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14465",
            "city": "POLAND",
            "state": "OH",
            "postal_code": "445147465",
            "telephone_number": "330-372-5550",
            "fax_number": "330-372-5551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2048 N RIVER RD NE # 3",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444832530",
            "telephone_number": "330-372-5550",
            "fax_number": "330-372-5551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS DIAGNOSTIC & REHABILITATION CENTER OF WARREN IN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-26",
        "last_updated": "2012-11-19",
        "status": "A",
        "authorized_official_last_name": "FARRELL",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "330-372-5550",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NR0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Radiology",
            "state": "OH",
            "license": "3569",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "OH",
            "license": "34.002093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2012; 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.