NPIMap

Organization Active NPI

Irvine Neuro Rehabilitation

  • Clinic/Center
  • Southfield, MI
National Provider Identifier
1972904209
Registry record updated Jul 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
IRVINE NEURO REHABILITATION
Practice address
25700 Lahser Rd
Southfield, MI 48033
Phone
(248) 415-2500
Fax
(248) 415-2510
NPI assigned
Sep 5, 2014
Last updated
Jul 2, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
IRVINE HEAD INJURY HOME, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 2, 2019

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

Authorized official

Name
Mrs. Artesia McNeal- Washington
Title
Administratior
Phone
(248) 415-2500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

25700 Lahser Rd
Southfield, MI 48033

Mailing address

30066 Pondsview Dr
Franklin, MI 48025-1524

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191106003332 MI Part B Supplier - Clinic/Group Practice 5395177695 Receives reassigned benefits from 4 practitioners
Practice locations: Southfield, MI

National Provider Directory

National Provider Directory
Part of
Irvine Head Injuryinc

Locations

25750 Lahser Rd
Southfield, MI 48033
Phone (248) 415-2500

Practitioners & affiliated clinicians

Practitioners 10

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": "1409875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562025600000",
    "number": "1972904209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30066 PONDSVIEW DR",
            "city": "FRANKLIN",
            "state": "MI",
            "postal_code": "480251524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25700 LAHSER RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "48033",
            "telephone_number": "248-415-2500",
            "fax_number": "248-415-2510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IRVINE NEURO REHABILITATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "IRVINE HEAD INJURY HOME, INC",
        "enumeration_date": "2014-09-05",
        "last_updated": "2019-07-02",
        "status": "A",
        "authorized_official_last_name": "MCNEAL- WASHINGTON",
        "authorized_official_first_name": "ARTESIA",
        "authorized_official_title_or_position": "ADMINISTRATIOR",
        "authorized_official_telephone_number": "248-415-2500",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2019; 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.