Organization Active NPI

Total Rehab, Inc

  • Physical Therapy Clinic/Center
  • Brandon, MS
National Provider Identifier
1740622539
Registry record updated Jul 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
PT3612 Issued in MS
Legal business name
TOTAL REHAB, INC
Practice address
307 Chartrese Dr
Brandon, MS 39047-8779
Phone
(601) 906-3718
NPI assigned
Jul 23, 2013
Last updated
Jul 26, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2016

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

Authorized official

Name
Scott Wayne Grantham, PT
Title
Physical Therapist/Owner
Phone
(601) 906-3718

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X PT3612 MS Primary
Physical Therapy Assistant 225200000X
Occupational Therapist 225X00000X

Addresses

Primary practice location

307 Chartrese Dr
Brandon, MS 39047-8779

Mailing address

307 Chartrese Dr
Brandon, MS 39047-8779

Other identifiers 1

IdentifierTypeStateIssuer
09504253MedicaidMS

National Provider Directory

National Provider Directory

Locations

2187B Highway 51
Madison, MS 39110
Phone (601) 906-3718

NPI Registry JSON

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

{
    "created_epoch": "1374537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469491200000",
    "number": "1740622539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 CHARTRESE DR",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390478779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 CHARTRESE DR",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390478779",
            "telephone_number": "601-906-3718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL REHAB, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-23",
        "last_updated": "2016-07-26",
        "status": "A",
        "authorized_official_last_name": "GRANTHAM",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST/OWNER",
        "authorized_official_telephone_number": "601-906-3718",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MS",
            "license": "PT3612",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09504253",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2016; 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.