NPIMap

Organization Active NPI

Drayer Physical Therapy Jackson LLC

Doing business as Performance Rehab

  • Physical Therapist
  • Richland, MS
National Provider Identifier
1780054072
Registry record updated Sep 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
DRAYER PHYSICAL THERAPY JACKSON LLC
Doing business as
Performance Rehab
Practice address
1201 Highway 49 S
Suite 2
Richland, MS 39218-9425
Phone
(769) 233-8844
Fax
(769) 251-1825
NPI assigned
Sep 30, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2015

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

Authorized official

Name
Eric J Williams
Title
President and Ceo
Phone
(717) 220-2100

Specialties & licenses 1

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

Addresses

Primary practice location

1201 Highway 49 S
Suite 2
Richland, MS 39218-9425

Mailing address

1201 Highway 49 S
Suite 2
Richland, MS 39218-9425
Phone (769) 233-8844

Other names 1

  • Performance Rehab Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Drayer Physical Therapy Jackson LLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1201 Highway 49 S
Ste 2
Richland, MS 39218
Phone (769) 233-8844

NPI Registry JSON

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

{
    "created_epoch": "1443571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443571200000",
    "number": "1780054072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 HIGHWAY 49 S",
            "address_2": "SUITE 2",
            "city": "RICHLAND",
            "state": "MS",
            "postal_code": "392189425",
            "telephone_number": "769-233-8844",
            "fax_number": "769-251-1825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 HIGHWAY 49 S",
            "address_2": "SUITE 2",
            "city": "RICHLAND",
            "state": "MS",
            "postal_code": "392189425",
            "telephone_number": "769-233-8844",
            "fax_number": "769-251-1825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRAYER PHYSICAL THERAPY JACKSON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-30",
        "last_updated": "2015-09-30",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "717-220-2100"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Performance Rehab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Richland, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2015; 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.