Individual provider Active NPI

Mariana Moreno

  • Physical Therapist
  • Columbia, MS
National Provider Identifier
1467339663
Registry record updated Aug 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8056 Issued in MS
Practice address
1215 Highway 98 Byp
Columbia, MS 39429-3702
Phone
(601) 444-5050
Fax
(601) 444-5072
NPI assigned
Aug 19, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2025

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 8056 MS Primary

Addresses

Primary practice location

1215 Highway 98 Byp
Columbia, MS 39429-3702

Mailing address

42465 Highway 195
Haleyville, AL 35565-7052
Phone (256) 350-1764

Other practice location 1

122 98 Place Blvd
Hattiesburg, MS 39402-8676
Phone (601) 268-0208

Other practice location 2

1044 Highway 42
Petal, MS 39465-2671
Phone (601) 544-0500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250922003970 MS Practitioner - Physical Therapist in Private Practice 1557866589 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Encore Rehabilitation, IncGroup PAC ID 3577462126, 182 clinicians

Practice addresses (Care Compare)

1215 Hwy 98 E
Columbia, MS 39429-3702
Phone (256) 350-1764

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Encore Rehabilitation, Inc. Physical Therapist CurrentSince Aug 25, 2025 Accepting new patients
Encore Rehabilitation, Inc. Physical Therapist CurrentSince Aug 25, 2025 Accepting new patients

Locations

251 Johnston St SE
Ste 300
Decatur, AL 35601
Phone (256) 340-9708

42465 Highway 195
Haleyville, AL 35565
Phone (205) 486-2753

1215 Highway 98 Byp
Columbia, MS 39429
Phone (601) 268-5070

122 98 Place Blvd
Hattiesburg, MS 39402
Phone (601) 268-0208

433 Main St
Leakesville, MS 39451
Phone (601) 394-4545

1044 Highway 42
Petal, MS 39465
Phone (601) 544-0500

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": "1755561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755561600000",
    "number": "1467339663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42465 HIGHWAY 195",
            "city": "HALEYVILLE",
            "state": "AL",
            "postal_code": "355657052",
            "telephone_number": "256-350-1764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 HIGHWAY 98 BYP",
            "city": "COLUMBIA",
            "state": "MS",
            "postal_code": "394293702",
            "telephone_number": "601-444-5050",
            "fax_number": "601-444-5072"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "122 98 Place Blvd",
            "address_purpose": "LOCATION",
            "city": "Hattiesburg",
            "state": "MS",
            "postal_code": "394028676",
            "country_code": "US",
            "telephone_number": "601-268-0208",
            "fax_number": "601-268-0440",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1044 Highway 42",
            "address_purpose": "LOCATION",
            "city": "Petal",
            "state": "MS",
            "postal_code": "394652671",
            "country_code": "US",
            "telephone_number": "601-544-0500",
            "fax_number": "601-544-0505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORENO",
        "first_name": "MARIANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-19",
        "last_updated": "2025-08-19",
        "certification_date": "2025-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "8056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2025; 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.