NPIMap

Organization Active NPI

MJF Rehabilitation PA

  • Physical Medicine & Rehabilitation Physician
  • Kerrville, TX
National Provider Identifier
1093778805
Registry record updated Sep 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
L3966 Issued in TX
Legal business name
MJF REHABILITATION PA
Practice address
551 Hill Country Dr
Kerrville, TX 78028-6085
Phone
(830) 315-2106
Fax
(830) 315-2108
NPI assigned
Apr 11, 2006
Last updated
Sep 18, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2019

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

Authorized official

Name
Dr. Mirelle Jeanne Foster, MDNPI 1780892877
Title
Member
Phone
(830) 315-2106

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X L3966 TX Primary

Addresses

Primary practice location

551 Hill Country Dr
Kerrville, TX 78028-6085

Mailing address

PO Box 290142
Kerrville, TX 78029-0142
Phone (830) 315-2106

Other identifiers 2

IdentifierTypeStateIssuer
008PZOtherTXBLUE CROSS BLUE SHIELD
152698001MedicaidTX

Other names 1

  • Professional Association Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080604000044 TX Part B Supplier - Clinic/Group Practice 3870663735 Receives reassigned benefits from 3 practitioners
Practice locations: Kerrville, TX

National Provider Directory

National Provider Directory

Locations

240 Wesley Dr
Kerrville, TX 78028
Phone (830) 257-3801

301 Junction Hwy
Ste 220
Kerrville, TX 78028
Phone (830) 792-7666

511 HL Country Dr
Kerrville, TX 78028

710 Water St
Fl 7
Kerrville, TX 78028
Phone (830) 258-7825

Practitioners & affiliated clinicians

Practitioners 23

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.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568764800000",
    "number": "1093778805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 290142",
            "city": "KERRVILLE",
            "state": "TX",
            "postal_code": "780290142",
            "telephone_number": "830-315-2106",
            "fax_number": "830-315-2108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "551 HILL COUNTRY DR",
            "city": "KERRVILLE",
            "state": "TX",
            "postal_code": "780286085",
            "telephone_number": "830-315-2106",
            "fax_number": "830-315-2108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MJF REHABILITATION PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-11",
        "last_updated": "2019-09-18",
        "status": "A",
        "authorized_official_last_name": "FOSTER",
        "authorized_official_first_name": "MIRELLE",
        "authorized_official_middle_name": "JEANNE",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "830-315-2106",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TX",
            "license": "L3966",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "008PZ",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "152698001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Professional Association",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Professional Association",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Kerrville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2019; 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.