NPIMap

Organization Active NPI

Neurosurgery Group P.C.

Doing business as Wellness Physical Medicine Center

  • Rehabilitation Clinic/Center
  • Clinton Township, MI
National Provider Identifier
1912944893
Registry record updated Sep 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
NEUROSURGERY GROUP P.C.
Doing business as
Wellness Physical Medicine Center
Practice address
43650 Garfield Rd
Clinton Township, MI 48038-1120
Phone
(586) 263-0820
NPI assigned
Jun 1, 2006
Last updated
Sep 18, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2007

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

Authorized official

Name
Dr. Mark Brennan, M.D.NPI 1225001746
Title
Administrator
Phone
(586) 263-0820

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 Primary

Addresses

Primary practice location

43650 Garfield Rd
Clinton Township, MI 48038-1120

Mailing address

43650 Garfield Rd
Clinton Township, MI 48038-1120

Other names 1

  • Wellness Physical Medicine Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041101000041 MI Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 2860483690 Practice locations: Clinton TWP, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1912944893. Details of each certification follow.

  • CCN 236588 Outpatient physical therapy / speech pathology · Active · Name & address match · Details

Outpatient physical therapy / speech pathology certification: CCN 236588

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
WELLNESS PHYSICAL MEDICINE CENTER
Certification status
Active
Provider type (POS)
Outpatient physical therapy / speech pathology
Participating since
Mar 6, 1991
Last certification
May 2, 2019
Ownership / control type
Proprietary
Facility address
43650 Garfield
Clinton Township, MI 48038

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Neurosurgery Group PC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190073600000",
    "number": "1912944893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43650 GARFIELD RD",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480381120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43650 GARFIELD RD",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480381120",
            "telephone_number": "586-263-0820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROSURGERY GROUP P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-01",
        "last_updated": "2007-09-18",
        "status": "A",
        "authorized_official_last_name": "BRENNAN",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "586-263-0820",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wellness Physical Medicine Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clinton Township, MI

Sources for this page

Verify at the official NPI Registry.