NPIMap

Organization Active NPI

Mountain West Rehabilitation Medicine PLLC

  • Physical Medicine & Rehabilitation Physician
  • Mesa, AZ
National Provider Identifier
1821433152
Registry record updated Apr 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
45968 Issued in AZ
Legal business name
MOUNTAIN WEST REHABILITATION MEDICINE PLLC
Practice address
255 W Brown Rd
Mesa, AZ 85201-3404
Phone
(480) 833-3988
Fax
(480) 962-1996
NPI assigned
Apr 30, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2013

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

Authorized official

Name
Richard J Kovan, MD
Title
Owner / Physician
Phone
(407) 797-3913

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X 45968 AZ Primary

Addresses

Primary practice location

255 W Brown Rd
Mesa, AZ 85201-3404

Mailing address

PO Box 678290
Dallas, TX 75267-8290
Phone (877) 749-7428

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1367280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367280000000",
    "number": "1821433152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 678290",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752678290",
            "telephone_number": "877-749-7428",
            "fax_number": "281-724-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 W BROWN RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852013404",
            "telephone_number": "480-833-3988",
            "fax_number": "480-962-1996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN WEST REHABILITATION MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-30",
        "last_updated": "2013-04-30",
        "status": "A",
        "authorized_official_last_name": "KOVAN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER / PHYSICIAN",
        "authorized_official_telephone_number": "407-797-3913",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "AZ",
            "license": "45968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2013; 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.