Sagamore Rehabilitation Center, Inc

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

SAGAMORE REHABILITATION CENTER, INC

Practice address

127 N Main St
Monticello, IN 47960-2130

Phone

(574) 808-3165

Fax

(574) 808-3166

NPI assigned

Dec 13, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Debra E Haworth, PT

Title

President

Phone

(765) 409-9006

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384128000000",
    "number": "1962563007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 N MAIN ST",
            "city": "MONTICELLO",
            "state": "IN",
            "postal_code": "479602130",
            "telephone_number": "574-808-3165",
            "fax_number": "574-808-3166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 N MAIN ST",
            "city": "MONTICELLO",
            "state": "IN",
            "postal_code": "479602130",
            "telephone_number": "574-808-3165",
            "fax_number": "574-808-3166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAGAMORE REHABILITATION CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2013-11-11",
        "status": "A",
        "authorized_official_last_name": "HAWORTH",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "765-409-9006",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200109430A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Monticello, IN
• Providers in Monticello, IN by specialty
• Physical Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2013; 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.