Upstate Medical Rehabilitation

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

UPSTATE MEDICAL REHABILITATION

Practice address

1003 Grove Rd
Suite E
Greenville, SC 29605-4626

Phone

(864) 232-8417

Fax

(864) 232-1511

NPI assigned

Dec 12, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Debbie J Underwood

Title

Business Administrator

Phone

(864) 232-8417

Specialties & licenses 1

Addresses

Other identifiers 8

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197417600000",
    "number": "1821158379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 GROVE RD",
            "address_2": "SUITE E",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054626",
            "telephone_number": "864-232-8417",
            "fax_number": "864-232-1511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 GROVE RD",
            "address_2": "SUITE E",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054626",
            "telephone_number": "864-232-8417",
            "fax_number": "864-232-1511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPSTATE MEDICAL REHABILITATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2007-12-12",
        "status": "A",
        "authorized_official_last_name": "UNDERWOOD",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "BUSINESS ADMINISTRATOR",
        "authorized_official_telephone_number": "864-232-8417",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1396799763",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1699727008",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1659325934",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP2707",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1013980168",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1962466276",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP1248",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAXONOMY",
            "identifier": "20810000X",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Medicine & Rehabilitation Physician in Greenville, SC
• Providers in Greenville, SC by specialty
• Physical Medicine & Rehabilitation Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2007; 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.