NPIMap

Organization Active NPI

Wing Neurological Rehab

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Phoenix, AZ
National Provider Identifier
1831470103
Registry record updated Sep 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Comprehensive Outpatient Rehabilitation Facility (CORF)Taxonomy code 261QR0401X
License
TSLP7413 Issued in AZ
Legal business name
WING NEUROLOGICAL REHAB
Practice address
1190 E Missouri Ave Ste 100
Phoenix, AZ 85014-2719
Phone
(480) 567-6717
NPI assigned
Aug 31, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2011

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

Authorized official

Name
Mary K. Wing
Title
Owner
Phone
(602) 393-0520

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Comprehensive Outpatient Rehabilitation Facility (CORF) 261QR0401X TSLP7413 AZ Primary

Addresses

Primary practice location

1190 E Missouri Ave Ste 100
Phoenix, AZ 85014-2719

Mailing address

1190 E Missouri Ave. Suite 100
Phoenix, AZ 85014
Phone (480) 567-6717

National Provider Directory

National Provider Directory
Tax ID family
Swan Rehab2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1314748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316131200000",
    "number": "1831470103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1190 E MISSOURI AVE. SUITE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85014",
            "telephone_number": "480-567-6717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1190 E MISSOURI AVE STE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850142719",
            "telephone_number": "480-567-6717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WING NEUROLOGICAL REHAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-31",
        "last_updated": "2011-09-16",
        "status": "A",
        "authorized_official_last_name": "WING",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-393-0520"
    },
    "taxonomies": [
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": "AZ",
            "license": "TSLP7413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2011; 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.