NPIMap

Organization Active NPI

Trinity Mission Health & Rehab of Clinton, LLC

  • Occupational Therapist
  • Clinton, MS
National Provider Identifier
1619206901
Registry record updated Apr 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
TRINITY MISSION HEALTH & REHAB OF CLINTON, LLC
Practice address
102 Woodchase Park Dr
Clinton, MS 39056-4113
Phone
(601) 924-7043
Fax
(601) 924-8633
NPI assigned
Dec 15, 2009
Organization subpart
Yes
Parent organization
COVENANT DOVE, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 12, 2012

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

Authorized official

Name
Christopher J Murphy
Title
Vice President
Phone
(901) 937-7994

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X Primary
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X

Addresses

Primary practice location

102 Woodchase Park Dr
Clinton, MS 39056-4113

Mailing address

102 Woodchase Park Dr
Clinton, MS 39056-4113
Phone (601) 924-7043

Other identifiers 1

IdentifierTypeStateIssuer
01902521MedicaidMS

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1260835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334188800000",
    "number": "1619206901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 WOODCHASE PARK DR",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "390564113",
            "telephone_number": "601-924-7043",
            "fax_number": "601-924-8633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 WOODCHASE PARK DR",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "390564113",
            "telephone_number": "601-924-7043",
            "fax_number": "601-924-8633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY MISSION HEALTH & REHAB OF CLINTON, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COVENANT DOVE, LLC",
        "enumeration_date": "2009-12-15",
        "last_updated": "2012-04-12",
        "status": "A",
        "authorized_official_last_name": "MURPHY",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "901-937-7994"
    },
    "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": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01902521",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Apr 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.