Provider Demographics
NPI:1457354748
Name:SUBURBAN/NRH MEDICAL REHABILITATION INC
Entity Type:Organization
Organization Name:SUBURBAN/NRH MEDICAL REHABILITATION INC
Other - Org Name:NRH REHABILITATION NETWORK AT BETHESDA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROCKWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-540-6140
Mailing Address - Street 1:102 IRVING ST NW
Mailing Address - Street 2:ATTN: MHPT PAYOR ENROLLMENT
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-2921
Mailing Address - Country:US
Mailing Address - Phone:301-540-6140
Mailing Address - Fax:301-540-5190
Practice Address - Street 1:6410 ROCKLEDGE DR STE 600
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-1844
Practice Address - Country:US
Practice Address - Phone:301-540-6140
Practice Address - Fax:301-540-5190
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MEDSTAR HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-05-31
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD271624OtherMAMSI BETHESDA
MD271645OtherMAMSI MONTROSE
DC3081OtherBLUESHIELD
MDKC76OtherBLUESHIELD
MD271644OtherMAMSI GERMANTOWN EXC
MD271647OtherMAMSI WHEATON
DC4071OtherBLUESHIELD PROF
MD271642OtherMAMSI FRIENDSHIP HGTS
MD271644OtherMAMSI GERMANTOWN SWC
DC896176Medicare PIN
MD216605Medicare Oscar/Certification