NPIMap

Organization Active NPI

Rehabilitation Services of Cleveland, Inc.

  • Physical Therapist
  • Cleveland, MS
National Provider Identifier
1710039656
Registry record updated Nov 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT1494 Issued in MS
Legal business name
REHABILITATION SERVICES OF CLEVELAND, INC.
Practice address
712 N Chrisman Ave
Suite C
Cleveland, MS 38732-2107
Phone
(662) 843-3004
Fax
(662) 843-0820
NPI assigned
Jan 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2010

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

Authorized official

Name
Mrs. Ann H. Herrick
Title
Billing
Phone
(662) 843-3004

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X PT1494 MS Primary
Occupational TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225X00000X OT0355 MS

Addresses

Primary practice location

712 N Chrisman Ave
Suite C
Cleveland, MS 38732-2107

Mailing address

712 N Chrisman Ave
Suite C
Cleveland, MS 38732-2107
Phone (662) 843-3004

Other identifiers 2

IdentifierTypeStateIssuer
00117948MedicaidMS
00117850MedicaidMS

National Provider Directory

National Provider Directory

Locations

712 N Chrisman Ave
Cleveland, MS 38732

712 N Chrisman Ave
Ste C
Cleveland, MS 38732
Phone (662) 843-3004

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": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288569600000",
    "number": "1710039656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 N CHRISMAN AVE",
            "address_2": "SUITE C",
            "city": "CLEVELAND",
            "state": "MS",
            "postal_code": "387322107",
            "telephone_number": "662-843-3004",
            "fax_number": "662-843-0820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 N CHRISMAN AVE",
            "address_2": "SUITE C",
            "city": "CLEVELAND",
            "state": "MS",
            "postal_code": "387322107",
            "telephone_number": "662-843-3004",
            "fax_number": "662-843-0820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REHABILITATION SERVICES OF CLEVELAND, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2010-11-01",
        "status": "A",
        "authorized_official_last_name": "HERRICK",
        "authorized_official_first_name": "ANN",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "BILLING",
        "authorized_official_telephone_number": "662-843-3004",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT1494",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "MS",
            "license": "OT0355",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00117948",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00117850",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2010; 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.