Restore, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

RESTORE, LLC

Practice address

101 S Lafayette St Ste 12
Starkville, MS 39759-2914

Phone

(662) 418-3108

NPI assigned

Feb 10, 2020

Organization subpart

No

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

Authorized official

Name

Mrs. Shannon Eastman Skelton, PTNPI 1376989095

Title

Owner

Phone

(662) 418-3108

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Shannon Eastman Skelton, PT

  • Physical Therapist
  • Starkville, MS
  • NPI 1376989095
  NPD Authorized official

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

{
    "created_epoch": "1581292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587859200000",
    "number": "1760014567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 TURNBERRY LN",
            "city": "STARKVILLE",
            "state": "MS",
            "postal_code": "397595508",
            "telephone_number": "662-418-3108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 S LAFAYETTE ST STE 12",
            "city": "STARKVILLE",
            "state": "MS",
            "postal_code": "397592914",
            "telephone_number": "662-418-3108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-10",
        "last_updated": "2020-04-26",
        "certification_date": "2020-04-26",
        "status": "A",
        "authorized_official_last_name": "SKELTON",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_middle_name": "EASTMAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "662-418-3108",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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