NPIMap

Organization Active NPI

Old Colony Rehabilitation LLC

  • Occupational Therapist
  • Port Gibson, MS
National Provider Identifier
1740060045
Registry record updated Oct 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
OLD COLONY REHABILITATION LLC
Practice address
6161 Highway 547
Port Gibson, MS 39150-2912
Phone
(601) 529-9084
NPI assigned
Oct 3, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2023

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

Authorized official

Name
Summer Fife, OTNPI 1013108430
Title
Owner
Phone
(601) 529-9084

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225X00000X Primary

Addresses

Primary practice location

6161 Highway 547
Port Gibson, MS 39150-2912

Mailing address

6161 Highway 547
Port Gibson, MS 39150-2912
Phone (601) 529-9084

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1696291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696291200000",
    "number": "1740060045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6161 HIGHWAY 547",
            "city": "PORT GIBSON",
            "state": "MS",
            "postal_code": "391502912",
            "telephone_number": "601-529-9084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6161 HIGHWAY 547",
            "city": "PORT GIBSON",
            "state": "MS",
            "postal_code": "391502912",
            "telephone_number": "601-529-9084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLD COLONY REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-03",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A",
        "authorized_official_last_name": "FIFE",
        "authorized_official_first_name": "SUMMER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-529-9084",
        "authorized_official_credential": "OT"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Gibson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2023; 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.