NPIMap

Organization Active NPI

Great Lakes Physical Medicine and Rehabilitation

  • Rehabilitation Clinic/Center
  • Wyandotte, MI
National Provider Identifier
1871794669
Registry record updated Mar 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
License
078199 Issued in MI
Legal business name
GREAT LAKES PHYSICAL MEDICINE AND REHABILITATION
Practice address
3247 Biddle Ave
Wyandotte, MI 48192-5951
Phone
(734) 287-3000
NPI assigned
May 30, 2007
Last updated
Mar 15, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2019

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

Authorized official

Name
Dr. Anne Abrahamson, M.D.NPI 1003870148
Title
Owner Physician
Phone
(313) 304-4818

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X 078199 MI Primary

Addresses

Primary practice location

3247 Biddle Ave
Wyandotte, MI 48192-5951

Mailing address

3247 Biddle Ave
Wyandotte, MI 48192-5951
Phone (734) 287-3000

Other practice location 1

40700 Woodward Ave
Suite A
Bloomfield Hills, MI 48304-5109
Phone (313) 304-4818

National Provider Directory

National Provider Directory

Locations

40700 Woodward Ave
Ste A
Bloomfield Hills, MI 48304
Phone (313) 304-4818

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552608000000",
    "number": "1871794669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3247 BIDDLE AVE",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481925951",
            "telephone_number": "734-287-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3247 BIDDLE AVE",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481925951",
            "telephone_number": "734-287-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "40700 Woodward Ave",
            "address_2": "Suite A",
            "address_purpose": "LOCATION",
            "city": "Bloomfield Hills",
            "state": "MI",
            "postal_code": "483045109",
            "country_code": "US",
            "telephone_number": "313-304-4818",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GREAT LAKES PHYSICAL MEDICINE AND REHABILITATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-30",
        "last_updated": "2019-03-15",
        "status": "A",
        "authorized_official_last_name": "ABRAHAMSON",
        "authorized_official_first_name": "ANNE",
        "authorized_official_title_or_position": "OWNER PHYSICIAN",
        "authorized_official_telephone_number": "313-304-4818",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "MI",
            "license": "078199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyandotte, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2019; 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.