Delta Therapy Solutions, LLC

Primary specialty

Rehabilitation Clinic/CenterTaxonomy code 261QR0400X

Legal business name

DELTA THERAPY SOLUTIONS, LLC

Practice address

610 Market St
Port Gibson, MS 39150-2330

Phone

(601) 437-3299

Fax

(601) 437-3298

NPI assigned

May 24, 2018

Last updated

Jan 19, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Betty Chiles

Title

Billing Office Manager

Phone

(318) 574-5273

Specialties & licenses 6

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1568953602. Details of each certification follow.

• CCN 256615 Outpatient physical therapy / speech pathology · Active · Name & address match · Details

Outpatient physical therapy / speech pathology certification: CCN 256615

Legal name

DELTA THERAPY SOLUTIONS, LLC

Certification status

Active

Provider type (POS)

Outpatient physical therapy / speech pathology

Participating since

Mar 25, 2019

Last certification

Nov 30, 2020

Ownership / control type

Proprietary

Facility address

610 Market Street
Port Gibson, MS 39150

Practitioners 3

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.

• Christopher B Deans, PT

  • Physical Therapist
  • Jackson, MS
  • NPI 1619040649
  NPD
• Robin Southerland Brown, OT

  • Occupational Therapy Assistant
  • Natchez, MS
  • NPI 1235277278
  NPD (past)
• Tammy Carol English, PT, DPT

  • Physical Therapist
  • Vicksburg, MS
  • NPI 1770665390
  NPD (past)

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

{
    "created_epoch": "1527120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674086400000",
    "number": "1568953602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 968",
            "city": "TALLULAH",
            "state": "LA",
            "postal_code": "712840968",
            "telephone_number": "318-574-5273",
            "fax_number": "318-574-2218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 MARKET ST",
            "city": "PORT GIBSON",
            "state": "MS",
            "postal_code": "391502330",
            "telephone_number": "601-437-3299",
            "fax_number": "601-437-3298"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1005 Johnson St",
            "address_purpose": "LOCATION",
            "city": "Tallulah",
            "state": "LA",
            "postal_code": "712825215",
            "country_code": "US",
            "telephone_number": "318-574-5273",
            "fax_number": "318-574-2218",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DELTA THERAPY SOLUTIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-24",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "status": "A",
        "authorized_official_last_name": "CHILES",
        "authorized_official_first_name": "BETTY",
        "authorized_official_title_or_position": "BILLING OFFICE MANAGER",
        "authorized_official_telephone_number": "318-574-5273"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02523574",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Latoya Denise Colenberg Eakins, D.M.D.
• Brenda Faye Collins, FNP-C
• Sheri T Collins, RPH
• Dan Ellis GNP Inc
• David M. Headley, M.D. PA
• Eli George Ellis Jr., DDS
• Edith Ifeyinwa Ezekwe, RDN, ASCP,
• Family Wellness Clinic LLC
• Summer Hayes Fife, MOTR/L
• Linda B Fouche

• Rehabilitation Clinic/Center in Port Gibson, MS
• Providers in Port Gibson, MS by specialty
• Rehabilitation Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.