Excelerated Rehab & Fitness LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

3116 Issued in MS

Legal business name

EXCELERATED REHAB & FITNESS LLC

Practice address

7 Willow Bend Dr
Hattiesburg, MS 39402-8552

Phone

(601) 599-0260

Fax

(601) 599-0261

NPI assigned

Dec 30, 2008

Last updated

Apr 23, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jennifer T Stewart, PTNPI 1972657807

Title

Owner

Phone

(601) 466-9938

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jennifer Tortorich Stewart, P.T.

  • Physical Therapist
  • Hattiesburg, MS
  • NPI 1972657807
  Authorized official Same address or phone

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

{
    "created_epoch": "1230595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271980800000",
    "number": "1083850770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 WILLOW BEND DR",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394028552",
            "telephone_number": "601-599-0260",
            "fax_number": "601-599-0261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 WILLOW BEND DR",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394028552",
            "telephone_number": "601-599-0260",
            "fax_number": "601-599-0261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCELERATED REHAB & FITNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-30",
        "last_updated": "2010-04-23",
        "status": "A",
        "authorized_official_last_name": "STEWART",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-466-9938",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MS",
            "license": "3116",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07526041",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Clinic/Center in Hattiesburg, MS
• Providers in Hattiesburg, 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 Apr 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.