NPIMap

Organization Active NPI

Modern Rehabilitation and Family Practice PC

  • Family Medicine Physician
  • Troy, MI
National Provider Identifier
1972880425
Registry record updated Nov 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301096806 Issued in MI
Legal business name
MODERN REHABILITATION AND FAMILY PRACTICE PC
Practice address
4379 Rochester Rd
Troy, MI 48085-4926
Phone
(248) 285-1656
NPI assigned
Nov 11, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2011

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

Authorized official

Name
Alain Goren, PTNPI 1396001814
Title
President
Phone
(248) 285-1656

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 4301096806 MI Primary

Addresses

Primary practice location

4379 Rochester Rd
Troy, MI 48085-4926

Mailing address

43314 Mound Rd
Sterling Heights, MI 48314-2022
Phone (248) 285-1656

National Provider Directory

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.

NPI Registry JSON

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

{
    "created_epoch": "1320969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320969600000",
    "number": "1972880425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43314 MOUND RD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483142022",
            "telephone_number": "248-285-1656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4379 ROCHESTER RD",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480854926",
            "telephone_number": "248-285-1656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN REHABILITATION AND FAMILY PRACTICE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-11",
        "last_updated": "2011-11-11",
        "status": "A",
        "authorized_official_last_name": "GOREN",
        "authorized_official_first_name": "ALAIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-285-1656",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301096806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2011; 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.