Organization Active NPI

Novacare Outpatient Rehabilitation East Inc

  • Physical Therapy Clinic/Center
  • Waterford, MI
National Provider Identifier
1821094202
Registry record updated Mar 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
NOVACARE OUTPATIENT REHABILITATION EAST INC
Practice address
1255 N Oakland Blvd
Ste 145
Waterford, MI 48327-1578
Phone
(248) 666-3329
Fax
(248) 666-5372
NPI assigned
Jun 22, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2008

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

Authorized official

Name
Mr. Michael E. Tarvin
Title
Vice President
Phone
(717) 975-4503

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X MI Primary

Addresses

Primary practice location

1255 N Oakland Blvd
Ste 145
Waterford, MI 48327-1578

Mailing address

4716 Old Gettysburg Rd.
Legal Deapartment
Mechanicsburg, PA 17055-4325
Phone (717) 975-4503

Other names 1

  • NovaCare Rehabilitation Doing business as

National Provider Directory

National Provider Directory

Locations

1255 N Oakland Blvd
Ste 145
Waterford, MI 48327
Phone (248) 666-3329

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": "1119398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205280000000",
    "number": "1821094202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4716 OLD GETTYSBURG RD.",
            "address_2": "LEGAL DEAPARTMENT",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170554325",
            "telephone_number": "717-975-4503",
            "fax_number": "717-975-9981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 N OAKLAND BLVD",
            "address_2": "STE 145",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483271578",
            "telephone_number": "248-666-3329",
            "fax_number": "248-666-5372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVACARE OUTPATIENT REHABILITATION EAST INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-22",
        "last_updated": "2008-03-12",
        "status": "A",
        "authorized_official_last_name": "TARVIN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "717-975-4503",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NovaCare Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waterford, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2008; 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.