Active NPI
Tarrah Rose
- Physical Therapy Assistant
- Marion, MS
National Provider Identifier
1649420829
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- PTA4421
- Practice address
- 6434 Dale Dr
Marion, MS 39342-8704 - Phone
- (601) 250-4815
- NPI assigned
- Sep 24, 2008
- Last updated
- Sep 29, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | PTA4421 | MS | Primary |
Addresses
Primary practice location
6434 Dale Dr
Marion, MS 39342-8704
Mailing address
737 Dogwood Lake Rd
Meridian, MS 39305-9235
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTA4421 | MS | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1222214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1222646400000",
"number": "1649420829",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "737 DOGWOOD LAKE RD",
"city": "MERIDIAN",
"state": "MS",
"postal_code": "393059235"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6434 DALE DR",
"city": "MARION",
"state": "MS",
"postal_code": "393428704",
"telephone_number": "601-250-4815"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSE",
"first_name": "TARRAH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-09-24",
"last_updated": "2008-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "MS",
"license": "PTA4421",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marion, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.