Momentum Rehabilitation Services, Inc.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

6301006431 Issued in MI

Legal business name

MOMENTUM REHABILITATION SERVICES, INC.

Practice address

7926 Ann Arbor St
Dexter, MI 48130-1344

Phone

(734) 320-2497

Fax

(810) 231-0771

NPI assigned

Apr 24, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Terry L Braciszewski, PHD

Title

Director

Phone

(734) 320-2497

Specialties & licenses 7

Addresses

Other identifiers 3

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sean C.F. Eaton, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Ann Arbor, MI
  • NPI 1437361425
  NPD (past)
• Valerie Ericson, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Ann Arbor, MI
  • NPI 1063763399
  NPD (past)
• Ginger Lynn Galardi, O.T.R.

  • Occupational Therapist
  • Ann Arbor, MI
  • NPI 1922214576
  NPD (past)
• Jagatheesan Saxon Govender, PH.D

  • Clinical Psychologist
  • Belleville, MI
  • NPI 1043579378
  NPD (past)

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398384000000",
    "number": "1730308115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8838 HENDRICKS DR",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481169111",
            "telephone_number": "734-320-2497",
            "fax_number": "810-231-0771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7926 ANN ARBOR ST",
            "city": "DEXTER",
            "state": "MI",
            "postal_code": "481301344",
            "telephone_number": "734-320-2497",
            "fax_number": "810-231-0771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOMENTUM REHABILITATION SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2014-04-25",
        "status": "A",
        "authorized_official_last_name": "BRACISZEWSKI",
        "authorized_official_first_name": "TERRY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "734-320-2497",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "MI",
            "license": "6301006431",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301006431",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "MI",
            "license": "6301006431",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301006431",
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Health Service",
            "state": "MI",
            "license": "6301006431",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "MI",
            "license": "6301006431",
            "primary": false
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Rehabilitation",
            "state": "MI",
            "license": "6301006431",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OWCS ACS",
            "identifier": "610093200",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "680H146930",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRUST",
            "identifier": "OD74512",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erin Miley
• Alexis Kay Miller, LMSW
• Jane Mitchell, RN
• Mary Elizabeth Moenssen, D.D.S., M.S.
• Momentum Rehab LLC
• Jenna Kathleen Mott, OTRL
• Robert John Mowry, MD
• Myint Family Chiropractic, Inc
• Stacey Lyn Myint, D.C.
• Mackenzie Lee Need

• Clinical Neuropsychologist in Dexter, MI
• Providers in Dexter, MI by specialty
• Clinical Neuropsychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2014; 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.