NPIMap

Organization Active NPI

Executive Rehab Services LTD.

  • Specialist
  • Newark, OH
National Provider Identifier
1972678100
Registry record updated Feb 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
EXECUTIVE REHAB SERVICES LTD.
Practice address
1945 Tamarack Rd
Newark, OH 43055-1300
Phone
(740) 349-9777
Fax
(740) 349-0787
NPI assigned
Nov 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2012

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

Authorized official

Name
Mrs. Lindsey Tate
Title
Business Director
Phone
(740) 349-8454

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

1945 Tamarack Rd
Newark, OH 43055-1300

Mailing address

1945 Tamarack Rd
Newark, OH 43055-1300
Phone (740) 349-9777

Other identifiers 1

IdentifierTypeStateIssuer
2811256MedicaidOH

National Provider Directory

National Provider Directory

Locations

51 N 3rd St
#202
Newark, OH 43055
Phone (740) 349-8454

1945 Tamarack Rd
Newark, OH 43055
Phone (740) 349-9777

Practitioners & affiliated clinicians

Practitioners 6

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": "1164153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328745600000",
    "number": "1972678100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1945 TAMARACK RD",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430551300",
            "telephone_number": "740-349-9777",
            "fax_number": "740-349-0787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1945 TAMARACK RD",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430551300",
            "telephone_number": "740-349-9777",
            "fax_number": "740-349-0787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXECUTIVE REHAB SERVICES LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-22",
        "last_updated": "2012-02-09",
        "status": "A",
        "authorized_official_last_name": "TATE",
        "authorized_official_first_name": "LINDSEY",
        "authorized_official_title_or_position": "BUSINESS DIRECTOR",
        "authorized_official_telephone_number": "740-349-8454",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2811256",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2012; 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.