NPIMap

Organization Active NPI

Sacred Heart Rehabilitation Center, Inc.

  • Community/Behavioral Health Agency
  • New Haven, MI
National Provider Identifier
1972701670
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
500441 Issued in MI
Legal business name
SACRED HEART REHABILITATION CENTER, INC.
Practice address
58144 Gratiot Ave
New Haven, MI 48048
Phone
(586) 749-5173
NPI assigned
Jul 5, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Grady Wilkinson
Title
President, Ceo
Phone
(810) 392-2167

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 500441 MI Primary

Addresses

Primary practice location

58144 Gratiot Ave
New Haven, MI 48048

Mailing address

400 Stoddard Rd
Memphis, MI 48041
Phone (810) 392-2167

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050712000553 MI Part B Supplier - Clinic/Group Practice 5395771240 Receives reassigned benefits from 37 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bay City, MI; Saint Ignace, MI; Saint Clair Shores, MI; Saginaw, MI; Richmond, MI; Port Huron, MI; Madison Heights, MI; Flint, MI…

Other NPIs on the same Medicare enrollment 13

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 13

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1183593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972701670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 STODDARD RD",
            "city": "MEMPHIS",
            "state": "MI",
            "postal_code": "48041",
            "telephone_number": "810-392-2167",
            "fax_number": "810-392-3530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58144 GRATIOT AVE",
            "city": "NEW HAVEN",
            "state": "MI",
            "postal_code": "48048",
            "telephone_number": "586-749-5173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SACRED HEART REHABILITATION CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILKINSON",
        "authorized_official_first_name": "GRADY",
        "authorized_official_title_or_position": "PRESIDENT, CEO",
        "authorized_official_telephone_number": "810-392-2167",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MI",
            "license": "500441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.