Active NPI
Pocono Functional Rehabilitation, PLLC
- Chiropractor
- Hawley, PA
National Provider Identifier
1811521115
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- Legal business name
- POCONO FUNCTIONAL REHABILITATION, PLLC
- Practice address
- 74 Welwood Ave Ste 101
Hawley, PA 18428-1577 - Phone
- (570) 226-4119
- NPI assigned
- Feb 25, 2020
- Last updated
- Feb 25, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Rae Marie Jacqueline Venarucci, DC
- Title
- Owner
- Phone
- (570) 226-4119
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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | Primary | ||
| Physical Therapist | 225100000X |
Addresses
Primary practice location
74 Welwood Ave Ste 101
Hawley, PA 18428-1577
Mailing address
74 Welwood Ave Ste 101
Hawley, PA 18428-1577
Phone (570) 226-4119
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
74 Welwood Ave
Ste 101
Hawley, PA 18428
Phone (570) 226-4119
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Chiropractor
- Hawley, PA
- NPI 1861579096
-
- Physical Therapist
- Taylor, PA
- NPI 1437604410
-
- Chiropractor
- Hawley, PA
- NPI 1316534316
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1582588800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1582588800000",
"number": "1811521115",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "74 WELWOOD AVE STE 101",
"city": "HAWLEY",
"state": "PA",
"postal_code": "184281577",
"telephone_number": "570-226-4119"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "74 WELWOOD AVE STE 101",
"city": "HAWLEY",
"state": "PA",
"postal_code": "184281577",
"telephone_number": "570-226-4119"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "POCONO FUNCTIONAL REHABILITATION, PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2020-02-25",
"last_updated": "2020-02-25",
"certification_date": "2020-02-25",
"status": "A",
"authorized_official_last_name": "VENARUCCI",
"authorized_official_first_name": "RAE MARIE",
"authorized_official_middle_name": "JACQUELINE",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "570-226-4119",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DC"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Chiropractor",
"state": null,
"license": null,
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hawley, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2020; 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.