SOUTHSIDE REHAB ASSOCIATES (NPI# 1104997972) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104997972 |
| Entity Type | Organization |
| Organization Name | SOUTHSIDE REHAB ASSOCIATES |
| Other Organization Name | SOUTHSIDE PHYSICAL THERAPY |
| Practice Address |
616 Meijer Dr Charlotte MI 48813-8376 |
| Mailing Address |
Po Box 558 Dewitt MI 48820-0558 |
| Practice Telephone | 5173338550 |
| Practice Fax Number | 5173338539 |
| Mailing Telephone | 5173338550 |
| Mailing Fax Number | 5173338539 |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2008-12-02 |
| Authorized Official Name | MR. LOUIS P FINOS (ADMINISTRATOR) |
| Authorized Official Telephone | 5173338550 |
| Authorized Official Credential | P.T. |
| Is Organization Subpart | Y |
| Parent Organization Name | SOUTHSIDE REHAB ASSOCIATES |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
5501001463 | MI | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Southside Physical Therapy | Doing Business As Name - Organization |
| Street Address |
616 MEIJER DR |
| City | CHARLOTTE |
| State | MI |
| Zip Code | 48813-8376 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255387858 | Charlotte Medical Center and Urgent Care, Pllc | Internal Medicine | 616 Meijer Dr, Charlotte, MI 48813-8376 | 2006-05-25 |
| 1154965952 | Nicole Roeske Pearson | Nurse Practitioner | 616 Meijer Dr, Charlotte, MI 48813-8457 | 2019-11-05 |
| 1609349802 | Kimberly Marie Comeau | Physician Assistant | 616 Meijer Dr, Charlotte, MI 48813-8457 | 2019-01-10 |
| 1235517574 | Amber Rae Sprague-rice | Nurse Practitioner | 616 Meijer Dr, Charlotte, MI 48813-8376 | 2015-05-07 |
| 1417385873 | Charlotte Family and Urgent Care Center, PC | Clinic/Center | 616 Meijer Dr, Charlotte, MI 48813-8376 | 2013-10-23 |
| 1780923763 | Nicholas Bradley Doman | Orthopaedic Surgery | 616 Meijer Dr, Charlotte, MI 48813-8457 | 2013-02-11 |
| 1902159478 | James Fradette | Physical Therapist | 616 Meijer Dr, Suite 106, Charlotte, MI 48813-8376 | 2012-10-22 |
| 1780904417 | Charlotte Medical Center & Urgent Care | Clinic/Center | 616 Meijer Dr, Charlotte, MI 48813-8376 | 2010-06-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982212072 | Alexandria Bower-nelson | Physician Assistant | 1302 Porter Drive, Charlotte, MI 48813 | 2020-07-15 |
| 1477052702 | Tayla Palacios | Occupational Therapy Assistant | 202 Warren St, Charlotte, MI 48813 | 2018-02-01 |
| 1043359417 | Frederic Wagner | Dentist | 229 S Cochran Avenue, Charlotte, MI 48813 | 2007-02-05 |
| 1154493971 | Debbie Haymowattee Hallak | Internal Medicine | 616 Meijer St, Charlotte, MI 48813 | 2006-11-15 |
| 1437171485 | Eaton County Health and Rehabilitation Services | Skilled Nursing Facility | 530 W Beech St, Charlotte, MI 48813 | 2006-07-25 |
| 1689694671 | Anthony E Marl | Internal Medicine | 123 Lansing St., Suite 3a, Charlotte, MI 48813 | 2006-07-20 |
| 1194754879 | Jeannine M Brake-norder | Optometrist | 123 Lansing Street, Charlotte, MI 48813 | 2006-07-03 |
| 1922537356 | Linda Gail Sherrill | Counselor | 114 E Lawrence Ave, Suite 130, Charlotte, MI 48813 | 2017-06-08 |
| 1801936000 | John D Curtis | Dentist | 229 S Cochran Avenue, Charlotte, MI 48813 | 2007-02-07 |
| 1811036262 | Painless Dentistry LLC | Dentist | 229 S Cochran Avenue, Charlotte, MI 48813 | 2007-02-05 |
| Find all providers in zip 48813 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295349231 | All Natural Female LLC | Clinic/Center | 10314 Kirkmont Dr, Charlotte, NC 28269-6219 | 2020-09-08 |
| 1538773064 | Congruency Therapy & Wellness LLC | Clinic/Center | 5045 Strawberry Hill Dr Apt D, Charlotte, NC 28211-4535 | 2020-09-02 |
| 1316563208 | Meaningful Movement LLC | Clinic/Center | 6314 Autumn Moss Ct, Charlotte, NC 28277-3514 | 2020-06-17 |
| 1952925885 | Inertia Physical Therapy LLC | Clinic/Center | 2700 Coltsgate Rd Ste 105, Charlotte, NC 28211-3573 | 2020-06-06 |
| 1063064061 | Go Pt First Inc. | Clinic/Center | 17059 Commons Creek Dr, Charlotte, NC 28277-2080 | 2019-07-10 |
| 1215596978 | Fundamental Physical Therapy LLC | Clinic/Center | 9517 Saddle Run Trl, Charlotte, NC 28269-0383 | 2019-06-06 |
| 1346808136 | Queen City Pelvic Pt | Clinic/Center | 5009 Erickson Rd, Charlotte, NC 28205-7319 | 2019-06-05 |
| 1639687965 | Pin Point Physical Therapy, LLC | Clinic/Center | 13939 Rocky Gap Ln, Charlotte, NC 28278-8615 | 2018-01-22 |
| 1932611324 | Charlotte One On One Physical Therapy | Clinic/Center | 4310 Park Rd Apt 103, Charlotte, NC 28209-0006 | 2017-10-25 |
| 1861934010 | Physical Therapy Center Two, LLC | Clinic/Center | 2400 South Blvd., Charlotte, NC 28203 | 2016-11-04 |
| Find all providers in CHARLOTTE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.