Jackson Rehab and Wellness Center

Primary specialty

Cardiopulmonary Physical TherapistTaxonomy code 2251C2600X

Legal business name

JACKSON REHAB AND WELLNESS CENTER

Practice address

5380 I-55 N
Suite 101
Jackson, MS 39211

Phone

(601) 316-8800

Fax

(601) 899-5198

NPI assigned

Dec 5, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Michael Kirtley

Title

Director

Phone

(601) 316-8800

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.

• Susan Deborah Andrews, MD

  • Family Medicine Physician
  • Ridgeland, MS
  • NPI 1942316377
  NPD (past)

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1285792010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5380 I-55 N",
            "address_2": "SUITE 101",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39211",
            "telephone_number": "601-316-8800",
            "fax_number": "601-899-5198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5380 I-55 N",
            "address_2": "SUITE 101",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39211",
            "telephone_number": "601-316-8800",
            "fax_number": "601-899-5198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON REHAB AND WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "KIRTLEY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "601-316-8800",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2251C2600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Cardiopulmonary",
            "state": "MS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B",
            "identifier": "C02912",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jackson Public Schools McWillie Clinic
• Jackson Public Schools Northwest Clinic
• Jackson Public Schools Timberlawn Clinic
• Jackson Pulmonary Associates, PA
• Jackson Radiology Assoc, PA
• Jackson State University
• Jackson State University
• Jackson Surgical Group PA
• Jackson Thyroid & Endocrine Clinic PLLC
• Jackson VA Medical Center

• All providers in Jackson, MS
• Cardiopulmonary Physical Therapist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.