NPIMap

Organization Active NPI

Northwest Rehabilitation

  • Physical Medicine & Rehabilitation Physician
  • Philadelphia, PA
National Provider Identifier
1720096746
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
NORTHWEST REHABILITATION
Practice address
255 S 17TH St
Suite 2001
Philadelphia, PA 19103-6231
Phone
(215) 546-7049
Fax
(215) 546-8646
NPI assigned
Aug 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Gregory Allen Nelson, M.D.
Title
Ceo
Phone
(215) 546-7049

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

255 S 17TH St
Suite 2001
Philadelphia, PA 19103-6231

Mailing address

255 S 17TH St
Suite 2001
Philadelphia, PA 19103-6231
Phone (215) 546-7049

National Provider Directory

National Provider Directory
Tax ID family
Multispeciality5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720096746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 S 17TH ST",
            "address_2": "SUITE 2001",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191036231",
            "telephone_number": "215-546-7049",
            "fax_number": "215-546-8646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 S 17TH ST",
            "address_2": "SUITE 2001",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191036231",
            "telephone_number": "215-546-7049",
            "fax_number": "215-546-8646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST REHABILITATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "215-546-7049",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.