Organization Active NPI

Maximum Mobility Rehabilitation & Fitness Inc

  • Physical Therapy Clinic/Center
  • Corinth, MS
National Provider Identifier
1487911269
Registry record updated Oct 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
MAXIMUM MOBILITY REHABILITATION & FITNESS INC
Practice address
125 Pratt Dr
Corinth, MS 38834-6040
Phone
(662) 415-6099
NPI assigned
Apr 18, 2012
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Mrs. Dusty D Kyle
Title
Manager
Phone
(662) 415-6099

Practitioners 1

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

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120606000508 MS Part B Supplier - Physical/Occupational Therapy Group in Private Practice 4385808153 Receives reassigned benefits from 1 practitioner
Practice locations: Corinth, MS

National Provider Directory

National Provider Directory

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

NPPES NPI Registry

Primary practice location

125 Pratt Dr
Corinth, MS 38834-6040

Mailing address

125 Pratt Dr
Corinth, MS 38834-6040
Phone (662) 415-6099

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 21, 2013.

{
    "created_epoch": "1334707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1382313600000",
    "number": "1487911269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 PRATT DR",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388346040",
            "telephone_number": "662-415-6099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 PRATT DR",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388346040",
            "telephone_number": "662-415-6099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAXIMUM MOBILITY REHABILITATION & FITNESS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-18",
        "last_updated": "2013-10-21",
        "status": "A",
        "authorized_official_last_name": "KYLE",
        "authorized_official_first_name": "DUSTY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "662-415-6099",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corinth, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2013; 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.