Macon Rehabilitation Services, LLC
Organization Active NPI Physical Therapy Clinic/Center · Macon, MO
NPI 1306197918 · NPPES record last updated Sep 21, 2012
Key facts
- NPI
- 1306197918
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapy Clinic/Center 261QP2000X
- License
- 20010108647 (MO)
- Legal business name
- MACON REHABILITATION SERVICES, LLC
- Practice address
- 106 Butler St
Suite C
Macon, MO 63552-1629 - Phone
- (660) 385-6244
- Fax
- (660) 385-4821
- NPI assigned
- Sep 21, 2012
- Organization subpart
- No
Authorized official
- Name
- Derek Bond
- Title
- Owner/Manager
- Phone
- (660) 385-6244
Practitioners 4
-
Savannah Marie Clark, DPT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20171214000478 | MO | Part B Supplier - Physical/Occupational Therapy Group in Private Practice | 1456500537 |
Receives reassigned benefits from 3 practitioners Practice locations: Macon, MO |
National Provider Directory
Locations
106 Butler St
Ste C
Macon, MO 63552
Phone (660) 385-6244
160 Butler St Ste C
Macon, MO 63552
1003 S Missouri St
Macon, MO 63552
Phone (660) 385-6244
32838 US Highway 63
Macon, MO 63552
Phone (660) 385-6244
112 Butler St
Macon, MO 63552
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Clinic/Center | 261QP2000X | 20010108647 | MO | Yes |
Addresses
Primary practice location
106 Butler St
Suite C
Macon, MO 63552-1629
Mailing address
106 Butler St
Suite C
Macon, MO 63552-1629
Phone (660) 385-6244
Other providers in Macon, MO
- Macon County Samaritan Hospital
- Macon County Samaritan Hospital
- Macon County Samaritan Hospital
- Macon County Samaritan Hospital
- Macon County Sheltered Workshop
- Mark Vincent Maddox
- Donet Christopher Main
- Jessica March
- William Walter Marshall II
- Matthew Theriac, D.D.S. LLC
All providers in Macon, MO · Physical Therapy Clinic/Center in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 21, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.