NPIMap

Organization Active NPI

Urban Rehab, Inc

Doing business as UR, Incorporated

  • Clinical Social Worker
  • Clinton, MS
National Provider Identifier
1417370313
Registry record updated Oct 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
M7217 Issued in MS
Legal business name
URBAN REHAB, INC
Doing business as
UR, Incorporated
Practice address
901 Highway 80 E
Clinton, MS 39056-5244
Phone
(601) 927-0188
Fax
(601) 292-7998
NPI assigned
Jan 28, 2014
Last updated
Oct 27, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2025

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

Authorized official

Name
Mr. Philip B Massey, LCSW, CADC IINPI 1306242458
Title
Executive Director
Phone
(601) 927-0188

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU
Addiction (Substance Use Disorder) Counselor 101YA0400X AD09-046M MS
Clinical Social Worker 1041C0700X M7217 MS Primary

Addresses

Primary practice location

901 Highway 80 E
Clinton, MS 39056-5244

Mailing address

PO Box 2305
Clinton, MS 39060-2305
Phone (601) 272-2202

Other practice location 1

4680 McWillie Dr
Jackson, MS 39206-5621
Phone (601) 272-2202

Other practice location 2

4111 N Port Washington Rd
Milwaukee, WI 53212-1029
Phone (601) 927-0188

Other identifiers 1

IdentifierTypeStateIssuer
06472833MedicaidMS

Other names 1

  • UR, Incorporated Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL https://urbanrehabinc.app.box.com/folder/0 Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20160328000462 MS Part B Supplier - Clinic/Group Practice 7012214638 Receives reassigned benefits from 6 practitioners
1 other NPI on this enrollment
Practice locations: Jackson, MS
O20260206001954 WI Part B Supplier - Clinic/Group Practice 7012214638 Receives reassigned benefits from 1 practitioner
Practice locations: Milwaukee, WI

Other NPIs with the same Medicare PAC ID 1

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

  • Urban Rehab, Inc
    • Mental Health Clinic/Center (Including Community Mental Health Center)
    • Clinton, MS
    • NPI 1003469743

    7012214638

    Same PAC ID

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Ur Incorporated2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

4576 Highway 80 W
Jackson, MS 39209
Phone (601) 272-2202

4680 McWillie Dr
Jackson, MS 39206
Phone (601) 272-2202

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1390867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761523200000",
    "number": "1417370313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2305",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "390602305",
            "telephone_number": "601-272-2202",
            "fax_number": "866-925-4488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 HIGHWAY 80 E",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "390565244",
            "telephone_number": "601-927-0188",
            "fax_number": "601-292-7998"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4680 McWillie Dr",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "392065621",
            "country_code": "US",
            "telephone_number": "601-272-2202",
            "fax_number": "866-925-4488",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4111 N Port Washington Rd",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532121029",
            "country_code": "US",
            "telephone_number": "601-927-0188",
            "fax_number": "601-292-7998",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "URBAN REHAB, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-28",
        "last_updated": "2025-10-27",
        "certification_date": "2025-10-27",
        "status": "A",
        "authorized_official_last_name": "MASSEY",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "601-927-0188",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW, CADC II"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MS",
            "license": "AD09-046M",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MS",
            "license": "M7217",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06472833",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://urbanrehabinc.app.box.com/folder/0",
            "affiliation": "N",
            "endpointDescription": "data and records exhange",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "pdf",
            "address_1": "901 Highway 80 E",
            "city": "Clinton",
            "state": "MS",
            "country_code": "US",
            "postal_code": "390565244",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "UR, Incorporated",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "UR, Incorporated",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clinton, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2025; 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.