Excel Physical Therapy and Wellness Center, PLLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

PT4493 Issued in MS

Legal business name

EXCEL PHYSICAL THERAPY AND WELLNESS CENTER, PLLC

Practice address

107 Amethyst LN
Brandon, MS 39047-6376

Phone

(601) 260-5767

NPI assigned

Jul 10, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Rashad Smith, PT, DPTNPI 1003174566

Title

Owner, Chief Executive Officer

Phone

(601) 260-5767

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Rashad Smith

  • Physical Therapist
  • Brandon, MS
  • NPI 1003174566
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1436486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440633600000",
    "number": "1043694946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 AMETHYST LN",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390476376",
            "telephone_number": "601-260-5767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 AMETHYST LN",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390476376",
            "telephone_number": "601-260-5767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCEL PHYSICAL THERAPY AND WELLNESS CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-10",
        "last_updated": "2015-08-27",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "RASHAD",
        "authorized_official_title_or_position": "OWNER, CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "601-260-5767",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MS",
            "license": "PT4493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayla Anthony Erickson, LPC
• Erin Green DDS PC
• Brian K Ervin
• Baron C Evans
• Picton Timothy Evans, PHARMD
• Mary E Fair
• Family Health Care Clinic, Inc
• Family Health Care Clinic, Inc.
• Joshua Taylor Farley, DPT
• Lauren Faulk

• Physical Therapy Clinic/Center in Brandon, MS
• Providers in Brandon, MS by specialty
• Physical Therapy Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2015; 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.