Individual provider Active NPI

Emily Rupp, PT, DPT

  • Physical Medicine & Rehabilitation Physician
  • Ridgeland, MS
National Provider Identifier
1629682802
Registry record updated Apr 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
1316353 Issued in TX
Practice address
205 Industrial CV
Ridgeland, MS 39157-2715
Phone
(877) 407-3422
Fax
(877) 407-4329
NPI assigned
Sep 3, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 1316353 TX Primary

Addresses

Primary practice location

205 Industrial CV
Ridgeland, MS 39157-2715

Mailing address

6210 Gibson LN Apt 6102
Texarkana, TX 75503-1256

Other practice location 1

74 Claiborne Way
Starkville, MS 39759-8544
Phone (877) 407-3422

Other practice location 2

2600 Saint Michael Dr
Texarkana, TX 75503-2372
Phone (603) 614-2874

Electronic endpoints 3

TypeEndpointUseAffiliation
CONNECT URL Texarakana
CONNECT URL https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler Other Fox Rehab Agency MS LLC
CONNECT URL https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler Other Fox Rehab Agency MS LLC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240613002821 MS Practitioner - Physical Therapist in Private Practice 1052854478 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1316353TXMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthpro Heritage Rehab & Fitness, LLC CurrentSince May 8, 2024 Accepting new patients
Drayer Physical Therapy Mississippi LLC CurrentSince May 27, 2024 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC CurrentSince May 8, 2024 Accepting new patients
Fox Rehab Agency Ms LLC CurrentSince Jul 1, 2024 Accepting new patients
Drayer Physical Therapy Mississippi LLC Past Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

117 Bo Bo Dr
Crystal Springs, MS 39059
Phone (601) 892-6330

100 Azalea Dr
Oxford, MS 38655
Phone (662) 234-9600

205 Industrial Cv
Ridgeland, MS 39157
Phone (601) 607-7820

74 Claiborne Way
Starkville, MS 39759
Phone (662) 268-9555

Organizations & group practices 5

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": "1599091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744761600000",
    "number": "1629682802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6210 GIBSON LN APT 6102",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755031256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 INDUSTRIAL CV",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391572715",
            "telephone_number": "877-407-3422",
            "fax_number": "877-407-4329"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "74 Claiborne Way",
            "address_purpose": "LOCATION",
            "city": "Starkville",
            "state": "MS",
            "postal_code": "397598544",
            "country_code": "US",
            "telephone_number": "877-407-3422",
            "fax_number": "877-407-4329",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2600 Saint Michael Dr",
            "address_purpose": "LOCATION",
            "city": "Texarkana",
            "state": "TX",
            "postal_code": "755032372",
            "country_code": "US",
            "telephone_number": "603-614-2874",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUPP",
        "first_name": "EMILY",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-03",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TX",
            "license": "1316353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Texarakana",
            "affiliation": "N",
            "address_1": "6210 Gibson Ln Apt 6102",
            "city": "Texarkana",
            "state": "TX",
            "country_code": "US",
            "postal_code": "755031256",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "Fox Rehab Agency MS LLC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "205 Industrial Cv",
            "city": "Ridgeland",
            "state": "MS",
            "country_code": "US",
            "postal_code": "391572715",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "Fox Rehab Agency MS LLC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "74 Claiborne Way",
            "city": "Starkville",
            "state": "MS",
            "country_code": "US",
            "postal_code": "397598544",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ridgeland, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 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.