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Organization Active NPI

Mississippi Methodist Hospital Rehabilitation Center Inc

Doing business as Methodist Rehab Center

  • Durable Medical Equipment & Medical Supplies
  • Meridian, MS
National Provider Identifier
1285772228
Registry record updated Nov 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
43-278 Issued in MS
Legal business name
MISSISSIPPI METHODIST HOSPITAL REHABILITATION CENTER INC
Doing business as
Methodist Rehab Center
Practice address
1600 14TH St
Meridian, MS 39301-4242
Phone
(601) 483-5280
NPI assigned
Feb 2, 2007
Last updated
Nov 20, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2012

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

Authorized official

Name
Gary Armstrong
Title
Exec Vice President
Phone
(601) 981-2611

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 43-278 MS Primary

Addresses

Primary practice location

1600 14TH St
Meridian, MS 39301-4242

Mailing address

1350 E Woodrow Wilson Ave
Jackson, MS 39216-5112
Phone (601) 981-2611

Other identifiers 1

IdentifierTypeStateIssuer
00040292MedicaidMS

Other names 1

  • Methodist Rehab Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930046819 MS DME Supplier - Medical Supply Company With Orthotic-ProstheticDME Supplier - Medical Supply Company With Prosthetic Personnel 8921912270 Practice locations: Meridian, MS

Other NPIs with the same Medicare PAC ID 13

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 13

National Provider Directory

National Provider Directory
Tax ID family
Methodist Rehab Center14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

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

View all 13

Locations

1600 14th St
Meridian, MS 39301
Phone (601) 483-5280

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Methodist Rehab CenterJackson, MS, CCN 25T152 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1975

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353369600000",
    "number": "1285772228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 E WOODROW WILSON AVE",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392165112",
            "telephone_number": "601-981-2611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 14TH ST",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393014242",
            "telephone_number": "601-483-5280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSISSIPPI METHODIST HOSPITAL REHABILITATION CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-02",
        "last_updated": "2012-11-20",
        "status": "A",
        "authorized_official_last_name": "ARMSTRONG",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "EXEC VICE PRESIDENT",
        "authorized_official_telephone_number": "601-981-2611"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MS",
            "license": "43-278",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00040292",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Methodist Rehab Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Meridian, MS

Sources for this page

Verify at the official NPI Registry.