Individual provider Active NPI

Emily Breland Underwood, MOTR/L

  • Occupational Therapist
  • Ridgeland, MS
National Provider Identifier
1316634843
Registry record updated Apr 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT-3539 Issued in MS
Practice address
950 E County Line Rd Ste a
Ridgeland, MS 39157-1928
Phone
(601) 487-6088
Fax
(601) 487-6068
NPI assigned
Apr 24, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT-3539 MS Primary

Addresses

Primary practice location

950 E County Line Rd Ste a
Ridgeland, MS 39157-1928

Mailing address

950 E County Line Rd Ste a
Ridgeland, MS 39157-1928
Phone (601) 487-6088

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230726001949 MS Practitioner - Occupational Therapist in Private Practice 3577924372 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fox Rehab Agency Ms LLCGroup PAC ID 2769841782, 66 clinicians

Practice addresses (Care Compare)

Starkville, MS 39759
Phone (877) 407-3422

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehab Agency Ms LLC Occupational Therapist CurrentSince Jun 1, 2023 Accepting new patients

Locations

74 Claiborne Way
Starkville, MS 39759
Phone (662) 268-9555

7 Carnegie Plz
Cherry Hill, NJ 08003

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1682294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682294400000",
    "number": "1316634843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 E COUNTY LINE RD STE A",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391571928",
            "telephone_number": "601-487-6088",
            "fax_number": "601-487-6068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 E COUNTY LINE RD STE A",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391571928",
            "telephone_number": "601-487-6088",
            "fax_number": "601-487-6068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UNDERWOOD",
        "first_name": "EMILY",
        "middle_name": "BRELAND",
        "credential": "MOTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-24",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MS",
            "license": "OT-3539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgeland, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.