NPIMap

Organization Active NPI

Core Rehab LLC

  • Physical Therapy Clinic/Center
  • Breckenridge, MI
National Provider Identifier
1780759571
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
5501010668 Issued in MI
Legal business name
CORE REHAB LLC
Practice address
1987 W Pine River Rd
Breckenridge, MI 48615
Phone
(989) 842-3460
Fax
(989) 842-5688
NPI assigned
Nov 21, 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
Mrs. Jamie Jill Staley, M.S.P.TNPI 1487717625
Title
President
Phone
(989) 842-3460

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
Physical Therapy Clinic/Center 261QP2000X 5501010668 MI Primary

Addresses

Primary practice location

1987 W Pine River Rd
Breckenridge, MI 48615

Mailing address

1987 W Pine River Rd
Breckenridge, MI 48615
Phone (989) 842-3460

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1780759571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1987 W PINE RIVER RD",
            "city": "BRECKENRIDGE",
            "state": "MI",
            "postal_code": "48615",
            "telephone_number": "989-842-3460",
            "fax_number": "989-842-5688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1987 W PINE RIVER RD",
            "city": "BRECKENRIDGE",
            "state": "MI",
            "postal_code": "48615",
            "telephone_number": "989-842-3460",
            "fax_number": "989-842-5688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORE REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STALEY",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_middle_name": "JILL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "989-842-3460",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.S.P.T"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MI",
            "license": "5501010668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Breckenridge, MI

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.