NPIMap

Organization Active NPI

Pro Health Aquisition Company

  • Physical Therapist
  • Kosciusko, MS
National Provider Identifier
1659316313
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PRO HEALTH AQUISITION COMPANY
Doing business as
Cornerstone Rehabilitation of Kosciusko
Practice address
140 N Wells St
Kosciusko, MS 39090-3637
Phone
(662) 290-6020
Fax
(662) 290-6070
NPI assigned
Jun 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Thomas L Windham
Title
Secretary/ Treasurer
Phone
(662) 473-3400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

140 N Wells St
Kosciusko, MS 39090-3637

Mailing address

50 S Main St
Water Valley, MS 38965-2946
Phone (662) 473-3400

Other identifiers 1

IdentifierTypeStateIssuer
04409521MedicaidMS

Other names 1

  • Cornerstone Rehabilitation of Kosciusko Doing business as

National Provider Directory

National Provider Directory

Locations

140 N Wells St
Kosciusko, MS 39090
Phone (662) 290-6020

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1659316313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 S MAIN ST",
            "city": "WATER VALLEY",
            "state": "MS",
            "postal_code": "389652946",
            "telephone_number": "662-473-3400",
            "fax_number": "662-473-4389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 N WELLS ST",
            "city": "KOSCIUSKO",
            "state": "MS",
            "postal_code": "390903637",
            "telephone_number": "662-290-6020",
            "fax_number": "662-290-6070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO HEALTH AQUISITION COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WINDHAM",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SECRETARY/ TREASURER",
        "authorized_official_telephone_number": "662-473-3400",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04409521",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cornerstone Rehabilitation of Kosciusko",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kosciusko, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.