Professional Rehabilitation Hospital LLC

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

Legal business name

PROFESSIONAL REHABILITATION HOSPITAL LLC

Practice address

107 Front St
Vidalia, LA 71373-2836

Phone

(318) 336-6500

NPI assigned

Apr 21, 2023

Organization subpart

Yes

Parent organization

PROFESSIONAL REHABILITATION HOSPITAL, LLCAs reported in NPPES

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

Authorized official

Name

Sonja Sharp Watkins

Title

Cfo

Phone

(601) 824-9010

Specialties & licenses 2

Addresses

Other names 1

• Riverbridge Pulmonary Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in LA, MS2 enrollments

Enrollment records 2

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Professional Rehabilitation Hospital LLC

  • Long Term Care Hospital
  • Vidalia, LA
  • NPI 1518929926

  6709865330

  Same PAC ID

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Professional Rehabilitation Hospital LLC

  • Long Term Care Hospital
  • Vidalia, LA
  • NPI 1518929926

  O20230501000349

  Same enrollment

Part of

Professional Rehabilitation Hospital LLC

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Professional Rehabilitation Hospital LLC

  • Long Term Care Hospital
  • Vidalia, LA
  • NPI 1518929926
  NPPES parent name

Practitioners 2

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

• Mohammad N. Alfarawati, M.D.

  • Pulmonary Disease Physician
  • Mount Pleasant, TX
  • NPI 1154582542

  MS

  Medicare reassignment NPD
• Emily L Hill, PA-C

  • Physician Assistant
  • Vidalia, LA
  • NPI 1952541534
  NPD

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

{
    "created_epoch": "1682035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692316800000",
    "number": "1639866353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 FRONT ST",
            "city": "VIDALIA",
            "state": "LA",
            "postal_code": "713732837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 FRONT ST",
            "city": "VIDALIA",
            "state": "LA",
            "postal_code": "713732836",
            "telephone_number": "318-336-6500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "209 Front St",
            "address_purpose": "LOCATION",
            "city": "Vidalia",
            "state": "LA",
            "postal_code": "713732837",
            "country_code": "US",
            "telephone_number": "318-336-6500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PROFESSIONAL REHABILITATION HOSPITAL LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROFESSIONAL REHABILITATION HOSPITAL, LLC",
        "enumeration_date": "2023-04-21",
        "last_updated": "2023-08-18",
        "certification_date": "2023-08-18",
        "status": "A",
        "authorized_official_last_name": "WATKINS",
        "authorized_official_first_name": "SONJA",
        "authorized_official_middle_name": "SHARP",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "601-824-9010"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Riverbridge Pulmonary Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Arthuanna Plater, FNP
• Bre'Anna Pollard
• Positive Choices Counseling Services Incorporated
• Zina Louise Prater II
• Professional Rehabilitation Hospital LLC
• Professional Trends, Inc.
• Victoria Profit
• Leketa Queen, RSW
• RCG Mississippi, Inc.
• Monique Reeed

• Pulmonary Disease Physician in Vidalia, LA
• Providers in Vidalia, LA by specialty
• Pulmonary Disease Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2023; 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.