Individual provider Active NPI

John Rayborn, PT

  • Physical Therapist
  • Collins, MS
National Provider Identifier
1386668259
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 1462 Issued in MS
Practice address
10 Melody LN
Collins, MS 39428-9002
Phone
(601) 765-2900
Fax
(601) 765-2903
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT 1462 MS Primary

Addresses

Primary practice location

10 Melody LN
Collins, MS 39428-9002

Mailing address

10 Melody LN
Collins, MS 39428-9002
Phone (601) 765-2900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070328000447 MS Practitioner - Physical Therapist in Private Practice 6507960721 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10 Melody LN
Collins, MS 39428-9002
Phone (601) 765-2900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT 1462MSMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Restore Physical Therapy Inc. CurrentSince Jan 1, 2007 Accepting new patients
Covington Rehabilitation & Hand Therapy LP Physical Therapist Past Accepting new patients

Locations

10 Melody Ln
Collins, MS 39428
Phone (601) 765-2900

Organizations & group practices 2

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386668259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 MELODY LN",
            "city": "COLLINS",
            "state": "MS",
            "postal_code": "394289002",
            "telephone_number": "601-765-2900",
            "fax_number": "601-765-2903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 MELODY LN",
            "city": "COLLINS",
            "state": "MS",
            "postal_code": "394289002",
            "telephone_number": "601-765-2900",
            "fax_number": "601-765-2903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYBORN",
        "first_name": "JOHN",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT 1462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Collins, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.