NPIMap

Organization Active NPI

Mobility Rehab LLC

  • Rehabilitation Clinic/Center
  • Ridgeland, MS
National Provider Identifier
1407376452
Registry record updated Jul 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
MOBILITY REHAB LLC
Practice address
745 S Pear Orchard Road
Apt 335
Ridgeland, MS 39157
Phone
(601) 573-9974
Fax
(601) 487-8546
NPI assigned
Jun 21, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2020

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

Authorized official

Name
Sarah Beckstead
Title
Office Manager
Phone
(601) 209-7697

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X Primary

Addresses

Primary practice location

745 S Pear Orchard Road
Apt 335
Ridgeland, MS 39157

Mailing address

PO Box 1227
Ridgeland, MS 39158-1227
Phone (601) 209-7697

Other practice location 1

5801 Eastdale Dr Apt 122
Montgomery, AL 36117-2160
Phone (601) 209-7697

Other names 1

  • Mobility Rehab LLC - Eastdale Estates Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171211001315 MS Part B Supplier - Physical/Occupational Therapy Group in Private Practice 3577821008 Receives reassigned benefits from 2 practitioners
Practice locations: Ridgeland, MS

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Mobility Rehab LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1498003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594598400000",
    "number": "1407376452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1227",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391581227",
            "telephone_number": "601-209-7697",
            "fax_number": "601-487-6169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "745 S PEAR ORCHARD ROAD",
            "address_2": "APT 335",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "39157",
            "telephone_number": "601-573-9974",
            "fax_number": "601-487-8546"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5801 Eastdale Dr Apt 122",
            "address_purpose": "LOCATION",
            "city": "Montgomery",
            "state": "AL",
            "postal_code": "361172160",
            "country_code": "US",
            "telephone_number": "601-209-7697",
            "fax_number": "601-487-6169",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MOBILITY REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-21",
        "last_updated": "2020-07-13",
        "certification_date": "2020-07-13",
        "status": "A",
        "authorized_official_last_name": "BECKSTEAD",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "601-209-7697"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mobility Rehab LLC - Eastdale Estates",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Jul 13, 2020; 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.