Organization Active NPI

Greater Health and Rehabilitation, LLC

  • Physical Medicine & Rehabilitation Physician
  • Cleburne, TX
National Provider Identifier
1841472115
Registry record updated Dec 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
GREATER HEALTH AND REHABILITATION, LLC
Practice address
306 Granbury St
Suite B
Cleburne, TX 76033-4853
Phone
(817) 641-9700
Fax
(817) 641-8190
NPI assigned
Nov 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2008

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

Authorized official

Name
Glen Tessman, DCNPI 1497875611
Title
Owner/Provider
Phone
(817) 641-9700

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)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 9660 TX
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

306 Granbury St
Suite B
Cleburne, TX 76033-4853

Mailing address

306 Granbury St
Suite B
Cleburne, TX 76033-4853
Phone (817) 641-9700

Other identifiers 2

IdentifierTypeStateIssuer
13QQOtherTXBCBS
DN8302OtherTXRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080530000472 TX Part B Supplier - Clinic/Group Practice 3971673195 Receives reassigned benefits from 1 practitioner
Practice locations: Cleburne, TX

National Provider Directory

National Provider Directory

Locations

201 N Ridgeway Dr
Cleburne, TX 76033
Phone (817) 641-9700

306 Granbury St
Ste B
Cleburne, TX 76033
Phone (817) 641-9700

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": "1196208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1230595200000",
    "number": "1841472115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 GRANBURY ST",
            "address_2": "SUITE B",
            "city": "CLEBURNE",
            "state": "TX",
            "postal_code": "760334853",
            "telephone_number": "817-641-9700",
            "fax_number": "817-641-8190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 GRANBURY ST",
            "address_2": "SUITE B",
            "city": "CLEBURNE",
            "state": "TX",
            "postal_code": "760334853",
            "telephone_number": "817-641-9700",
            "fax_number": "817-641-8190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER HEALTH AND REHABILITATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-28",
        "last_updated": "2008-12-30",
        "status": "A",
        "authorized_official_last_name": "TESSMAN",
        "authorized_official_first_name": "GLEN",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "817-641-9700",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "9660",
            "primary": false
        },
        {
            "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": "BCBS",
            "identifier": "13QQ",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "DN8302",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleburne, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2008; 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.

Verify at the official NPI Registry.