NPIMap

Organization Active NPI

Polk Rehabilitation Services, Inc.

  • Physical Medicine & Rehabilitation Physician
  • Jackson, MS
National Provider Identifier
1265610265
Registry record updated Feb 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
POLK REHABILITATION SERVICES, INC.
Practice address
4798 McWillie Dr
Jackson, MS 39206-5608
Phone
(601) 362-7649
NPI assigned
Feb 1, 2008
Organization subpart
No

Practitioners 1

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

National Provider Directory

National Provider Directory

Locations

4798 McWillie Dr
Jackson, MS 39206
Phone (601) 362-7649

NPPES NPI Registry

Updated by the provider on Feb 1, 2008

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

Authorized official

Name
Jo Lynn PolkNPI 1487664173
Title
President
Phone
(601) 238-1047

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 PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

4798 McWillie Dr
Jackson, MS 39206-5608

Mailing address

4798 McWillie Dr
Jackson, MS 39206-5608
Phone (601) 362-7649

NPI Registry JSON

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

{
    "created_epoch": "1201824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201824000000",
    "number": "1265610265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4798 MCWILLIE DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392065608",
            "telephone_number": "601-362-7649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4798 MCWILLIE DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392065608",
            "telephone_number": "601-362-7649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POLK REHABILITATION SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-01",
        "last_updated": "2008-02-01",
        "status": "A",
        "authorized_official_last_name": "POLK",
        "authorized_official_first_name": "JO LYNN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "601-238-1047"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 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.