Organization Active NPI

Spence Rehabilitation Center, P.C.

  • Physical Medicine & Rehabilitation Physician
  • Highland, IN
National Provider Identifier
1801072962
Registry record updated Jun 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
SPENCE REHABILITATION CENTER, P.C.
Practice address
3737 45TH St Ste 1
Highland, IN 46322-3008
Phone
(219) 513-2267
Fax
(219) 510-5483
NPI assigned
Jan 18, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2024

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

Authorized official

Name
Dr. Michael J. Spence, M.D.NPI 1558388157
Title
President
Phone
(219) 513-2267

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 Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

3737 45TH St Ste 1
Highland, IN 46322-3008

Mailing address

3737 45TH St Ste 1
Highland, IN 46322-3008
Phone (219) 513-2267

Other identifiers 1

IdentifierTypeStateIssuer
200885930AMedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080410000015 IN Part B Supplier - Clinic/Group Practice 9234216656 Receives reassigned benefits from 1 practitioner
Practice locations: Highland, IN

National Provider Directory

National Provider Directory

Locations

3737 45th St
#1
Highland, IN 46322
Phone (219) 513-2267

1650 45th St
Ste 2C
Munster, IN 46321
Phone (219) 513-2267

1101 Glendale Blvd
Ste 107A
Valparaiso, IN 46383
Phone (219) 286-6888

Practitioners & affiliated clinicians

Practitioners 3

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": "1200614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719446400000",
    "number": "1801072962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3737 45TH ST STE 1",
            "city": "HIGHLAND",
            "state": "IN",
            "postal_code": "463223008",
            "telephone_number": "219-513-2267",
            "fax_number": "219-513-2267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3737 45TH ST STE 1",
            "city": "HIGHLAND",
            "state": "IN",
            "postal_code": "463223008",
            "telephone_number": "219-513-2267",
            "fax_number": "219-510-5483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPENCE REHABILITATION CENTER, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-18",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A",
        "authorized_official_last_name": "SPENCE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "219-513-2267",
        "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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200885930A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 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.