Center for Physical Medicine and Rehabilitiation

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

CENTER FOR PHYSICAL MEDICINE AND REHABILITIATION

Practice address

13850 E 12 Mile Rd
2-B
Warren, MI 48088-3730

Phone

(586) 552-4499

Fax

(586) 552-4878

NPI assigned

Apr 24, 2008

Organization subpart

No

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

Authorized official

Name

Robert A Krasnick, MD

Title

President

Phone

(586) 552-4499

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Complete Orthotics Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Center for Physical Medicine & Rehabilitation PC

  • Specialist
  • Warren, MI
  • NPI 1003993312

  O20040323001725

  Same enrollment
• Center for Physical Medicine and Rehabilitation PC

  • Durable Medical Equipment & Medical Supplies
  • Warren, MI
  • NPI 1053595199

  O20040323001725

  Same enrollment

Tax ID family

Center for Physical Medicine and Rehabilitation PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Center for Physical Medicine and Rehabilitation PC

  • Durable Medical Equipment & Medical Supplies
  • Warren, MI
  • NPI 1053595199
  NPD tax ID

Locations

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

{
    "created_epoch": "1208995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208995200000",
    "number": "1790950459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13850 E 12 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480883730",
            "telephone_number": "586-552-4499",
            "fax_number": "586-552-4878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13850 E 12 MILE RD",
            "address_2": "2-B",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480883730",
            "telephone_number": "586-552-4499",
            "fax_number": "586-552-4878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR PHYSICAL MEDICINE AND REHABILITIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-24",
        "last_updated": "2008-04-24",
        "status": "A",
        "authorized_official_last_name": "KRASNICK",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "586-552-4499",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "540O020680",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Complete Orthotics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Carla Evangeline Caudill
• Sabina Causevic X, RN
• Desire Zane Causey
• Center for Physical Medicine & Rehabilitation PC
• Center for Physical Medicine and Rehabilitation PC
• Center for Weight Management
• Century Multipurpose Services,LLC
• Angela N Cergnul, D.D.S.
• Mustafa Chahrour
• Chairat Chomchai M.D P.C

• Durable Medical Equipment & Medical Supplies in Warren, MI
• Providers in Warren, MI by specialty
• Durable Medical Equipment & Medical Supplies in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2008; 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.