Macon Rehabilitation Services, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

20010108647 Issued in 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

Last updated

Sep 21, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Derek BondNPI 1114274503

Title

Owner/Manager

Phone

(660) 385-6244

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Derek Bond

  • Physical Therapist
  • Macon, MO
  • NPI 1114274503
  Medicare reassignment Care Compare group NPD Authorized official
• Savannah Marie Clark, DPT

  • Physical Therapist
  • Macon, MO
  • NPI 1891429122
  Medicare reassignment Care Compare group NPD
• Jessica Lynn McClintock, DPT

  • Physical Therapist
  • Hannibal, MO
  • NPI 1023306586
  Medicare reassignment Care Compare group
• Kathy S Abernathy, PT

  • Physical Therapist
  • Macon, MO
  • NPI 1386636793
  NPD (past)

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

{
    "created_epoch": "1348185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348185600000",
    "number": "1306197918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 BUTLER ST",
            "address_2": "SUITE C",
            "city": "MACON",
            "state": "MO",
            "postal_code": "635521629",
            "telephone_number": "660-385-6244",
            "fax_number": "660-385-4821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 BUTLER ST",
            "address_2": "SUITE C",
            "city": "MACON",
            "state": "MO",
            "postal_code": "635521629",
            "telephone_number": "660-385-6244",
            "fax_number": "660-385-4821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MACON REHABILITATION SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-21",
        "last_updated": "2012-09-21",
        "status": "A",
        "authorized_official_last_name": "BOND",
        "authorized_official_first_name": "DEREK",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "660-385-6244"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MO",
            "license": "20010108647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Macon County Samaritan Hospital
• Macon County Samaritan Hospital (Samaritan Hospital)
• Macon County Samaritan Hospital (Total Family Healthcare)
• Macon County Samaritan Hospital
• Macon County Sheltered Workshop (Macon Diversified Industries)
• Mark Vincent Maddox, O.D.
• Donet Christopher Main, DO
• Jessica March, MSN, FNP-BC
• William Walter Marshall II, D.D.S.
• Matthew Theriac, D.D.S. LLC

• Physical Therapy Clinic/Center in Macon, MO
• Providers in Macon, MO by specialty
• Physical Therapy Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.