Regina Ann Scott, OTRL

Individual provider Active NPI Occupational Therapist · Florence, MS

NPI 1063544005 · NPPES record last updated May 21, 2013

Key facts

NPI
1063544005
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
1201 (MS)
Practice address
260 Barnes Rd
Florence, MS 39073-8066
Phone
(601) 845-0876
NPI assigned
Mar 12, 2007
Sex
Female
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CO

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20211228001931 CO Practitioner - Occupational Therapist in Private Practice 1557752656 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
1201MSMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain Home Therapy Occupational Therapist Current
since Sep 29, 2021
Accepting new patients
Trail Blazin Therapy LLC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 1201 MS Yes

Addresses

Primary practice location

260 Barnes Rd
Florence, MS 39073-8066

Mailing address

665 Holly Grove Cir
Braxton, MS 39044-2963
Phone (601) 847-0430

Other identifiers

IdentifierTypeStateIssuer
02759579MedicaidMS

Other providers in Florence, MS

All providers in Florence, MS · Occupational Therapist in Mississippi

Sources for this page

Verify at the official NPI Registry.