NPIMap

Organization Active NPI

River City Rehabilitation LLC

  • Physical Therapist
  • Greenville, MS
National Provider Identifier
1083607220
Registry record updated Jul 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT1045 Issued in MS
Legal business name
RIVER CITY REHABILITATION LLC
Practice address
1707 South Colorado
Suite a
Greenville, MS 38703
Phone
(662) 335-8332
Fax
(662) 335-8852
NPI assigned
Aug 23, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2025

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

Authorized official

Name
Ms. Gina L Ashford
Title
Manager
Phone
(662) 335-8332

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X PT1045 MS Primary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X OT0169 MS

Addresses

Primary practice location

1707 South Colorado
Suite a
Greenville, MS 38703

Mailing address

1707 South Colorado
Suite a
Greenville, MS 38703
Phone (662) 335-8332

Other identifiers 1

IdentifierTypeStateIssuer
09015486MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080516000102 MS Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 0749359719 Practice locations: Greenville, MS
O20100930031461 MS DME Supplier - Independently-Practicing Physical TherapistDME Supplier - Independently-Practicing Occupational Therapist 0749359719 Practice locations: Greenville, MS

National Provider Directory

National Provider Directory

Locations

1707 S Colorado St
#A
Greenville, MS 38703
Phone (662) 335-8332

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751846400000",
    "number": "1083607220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1707 SOUTH COLORADO",
            "address_2": "SUITE A",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "38703",
            "telephone_number": "662-335-8332",
            "fax_number": "662-335-8852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1707 SOUTH COLORADO",
            "address_2": "SUITE A",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "38703",
            "telephone_number": "662-335-8332",
            "fax_number": "662-335-8852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVER CITY REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-23",
        "last_updated": "2025-07-07",
        "certification_date": "2025-07-07",
        "status": "A",
        "authorized_official_last_name": "ASHFORD",
        "authorized_official_first_name": "GINA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "662-335-8332",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT1045",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "MS",
            "license": "OT0169",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09015486",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2025; 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.