Prime Rehabilitation LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

PRIME REHABILITATION LLC

Doing business as

ACCUA Advanced Rehabilitation

Practice address

8690 Eagle Creek Pkwy
Savage, MN 55378-1284

Phone

(952) 412-6207

Fax

(952) 487-2829

NPI assigned

Jul 25, 2007

Organization subpart

No

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

Authorized official

Name

Jeffrey Leonard Kallberg, PT

Title

President

Phone

(952) 412-6207

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• ACCUA Advanced Rehabilitation Doing business as

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

{
    "created_epoch": "1185321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211414400000",
    "number": "1902096167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8690 EAGLE CREEK PKWY",
            "city": "SAVAGE",
            "state": "MN",
            "postal_code": "553781284",
            "telephone_number": "952-412-6207",
            "fax_number": "952-487-2829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8690 EAGLE CREEK PKWY",
            "city": "SAVAGE",
            "state": "MN",
            "postal_code": "553781284",
            "telephone_number": "952-412-6207",
            "fax_number": "952-487-2829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-25",
        "last_updated": "2008-05-22",
        "status": "A",
        "authorized_official_last_name": "KALLBERG",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "LEONARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "952-412-6207",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD OF MINNESOTA",
            "identifier": "160D2KA",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "600088600",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ACCUA Advanced Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Nancy A Quinones, PHARMD
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• Betty Jean Rainwater

• Physical Therapy Clinic/Center in Savage, MN
• Providers in Savage, MN by specialty
• Physical Therapy Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2008; 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.