Rehab on the Road, PSC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

31321 Issued in KY

Legal business name

REHAB ON THE ROAD, PSC

Practice address

800 Man O War Blvd
Union, KY 41091-8067

Phone

(502) 645-1053

Fax

(888) 390-7623

NPI assigned

Sep 30, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Kenneth Allan Mook, MD, PHD

Title

Physician

Phone

(502) 645-1053

Specialties & licenses 1

Addresses

Other identifiers 8

Locations

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

{
    "created_epoch": "1222732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350432000000",
    "number": "1811148547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 MAN O WAR BLVD",
            "city": "UNION",
            "state": "KY",
            "postal_code": "410918067",
            "telephone_number": "502-645-1053",
            "fax_number": "888-390-7623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 MAN O WAR BLVD",
            "city": "UNION",
            "state": "KY",
            "postal_code": "410918067",
            "telephone_number": "502-645-1053",
            "fax_number": "888-390-7623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REHAB ON THE ROAD, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-30",
        "last_updated": "2012-10-17",
        "status": "A",
        "authorized_official_last_name": "MOOK",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "ALLAN",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "502-645-1053",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, PHD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "KY",
            "license": "31321",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER #",
            "identifier": "000000074661",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200179480A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT",
            "identifier": "1102772",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT ADVANTAGE",
            "identifier": "2436318000",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64-313216",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "P00003391",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1285608752",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "250010583",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Olivia Prehodka
• Melonie C Proctor, DO
• Joann Puckett, RN
• Amanda Leigh Race, APRN
• Michelle Raleigh, NP
• Jeff Thomas Reinstatler, DPT
• Danita Carelle Roberts Osborne, MCD, CCC-SLP
• Sabrina Roberts
• Elizabeth R Rock, M.A. CCC-SLP
• Janna Roller, RN

• Physical Medicine & Rehabilitation Physician in Union, KY
• Providers in Union, KY by specialty
• Physical Medicine & Rehabilitation Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2012; 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.