Professional Quality Rehab Services,Inc

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501007308 Issued in MI

Legal business name

PROFESSIONAL QUALITY REHAB SERVICES,INC

Practice address

7460 Dry Creek Dr Apt 2a
Grand Blanc, MI 48439-6313

Phone

(810) 265-3882

Fax

(810) 963-0560

NPI assigned

Oct 29, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Madhavan Krishnamoorthy, PTNPI 1366621294

Title

President

Phone

(810) 230-0891

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 1

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

• Madhavan Krishnamoorthy, PT

  • Physical Therapist
  • Grand Blanc, MI
  • NPI 1366621294
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1193616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704153600000",
    "number": "1760661631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7460 DRY CREEK DR APT 2A",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484396313",
            "telephone_number": "810-265-3882",
            "fax_number": "810-963-0560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7460 DRY CREEK DR APT 2A",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484396313",
            "telephone_number": "810-265-3882",
            "fax_number": "810-963-0560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL QUALITY REHAB SERVICES,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-29",
        "last_updated": "2024-01-02",
        "certification_date": "2024-01-02",
        "status": "A",
        "authorized_official_last_name": "KRISHNAMOORTHY",
        "authorized_official_first_name": "MADHAVAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "810-230-0891",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501007308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison McKenna Price
• Rachel E Price
• Andrew Todd Priestap
• Lisa Priestap
• Professional Home Health Care LLC
• Sharon Louise Pruder, NNP-BC
• Melissa Ann Pruski, MD
• Sandra Ann Przybysz, MA, LPC
• Psychiatric Consultants of Grand Blanc PLLC
• Rishi Kailash Pularu

• Physical Therapist in Grand Blanc, MI
• Providers in Grand Blanc, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2024; 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.