Organization Active NPI

Regional Rehabilitation Center, Inc.

  • Audiologist
  • Tupelo, MS
National Provider Identifier
1194979120
Registry record updated Nov 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
A0737 Issued in MS
Legal business name
REGIONAL REHABILITATION CENTER, INC.
Practice address
615 Pegram Dr
Tupelo, MS 38801-6321
Phone
(662) 842-1891
Fax
(662) 840-0941
NPI assigned
Nov 4, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2008

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

Authorized official

Name
Ms. Vicki Butler Gaillard, CCC-A
Title
Audiologist
Phone
(662) 842-1891

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
AudiologistGroup: 193200000X MULTI-SPECIALTY GROUP 231H00000X A0737 MS Primary

Addresses

Primary practice location

615 Pegram Dr
Tupelo, MS 38801-6321

Mailing address

615 Pegram Dr
Tupelo, MS 38801-6321
Phone (662) 842-1891

Other identifiers 1

IdentifierTypeStateIssuer
0770476MedicaidMS

National Provider Directory

National Provider Directory
Tax ID family
Regional Rehab2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

615 Pegram Dr
Tupelo, MS 38801
Phone (662) 840-0974

NPI Registry JSON

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

{
    "created_epoch": "1225756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225756800000",
    "number": "1194979120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 PEGRAM DR",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388016321",
            "telephone_number": "662-842-1891",
            "fax_number": "662-840-0941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 PEGRAM DR",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388016321",
            "telephone_number": "662-842-1891",
            "fax_number": "662-840-0941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGIONAL REHABILITATION CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-04",
        "last_updated": "2008-11-04",
        "status": "A",
        "authorized_official_last_name": "GAILLARD",
        "authorized_official_first_name": "VICKI",
        "authorized_official_middle_name": "BUTLER",
        "authorized_official_title_or_position": "AUDIOLOGIST",
        "authorized_official_telephone_number": "662-842-1891",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "CCC-A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Audiologist",
            "state": "MS",
            "license": "A0737",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0770476",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tupelo, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2008; 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.