Mississippi Methodist Hospital & Rehabilitation Center, Inc.
Organization Active NPI Physical Medicine & Rehabilitation Physician · Jackson, MS
NPI 1790711273 · NPPES record last updated Oct 15, 2010
Key facts
- NPI
- 1790711273
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Medicine & Rehabilitation Physician 208100000X
- License
- 43-278 (MS)
- Legal business name
- MISSISSIPPI METHODIST HOSPITAL & REHABILITATION CENTER, INC.
- Practice address
- 1350 E Woodrow Wilson Ave
Jackson, MS 39216-5112 - Phone
- (601) 981-2611
- Fax
- (601) 364-5369
- NPI assigned
- Jun 25, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Gary Armstrong
- Title
- Executive Vice President
- Phone
- (601) 364-3365
Owned or controlled facilities with NPI records 1
Other NPIs with the same Medicare PAC ID 13
Practitioners 62
-
Philip J Blount, M.D.
-
Ryan McGaughey, M.D.
-
Rhonda B Meadows, NP-C
-
Alice F Messer, CFNP
-
Kalisa K Ramsey, CFNP
-
Michael H Winkelmann, M.D.
-
Kristi H Goodson, CFNP
-
Leslie Ann Fisher, FNP-C
-
Natalie Renea Keyes, FNP
-
Nakecia Dungan Kinabrew, FNP-BC
-
Sandra S Langston, CFNP
-
Lynn Carol Sharp, APRN
-
Shaneka Latrisha Simmons, FNP-C
-
Barbara Ann Tolleson, CFNP
-
Douglas Tucker, M.D.
-
Erica Dillon Walker, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| Methodist Rehab Center |
Hospital | 5% Or Greater Direct Ownership Interest (100%) | Jan 1, 1975 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20051005001042 | MS | Part B Supplier - Hospital Department(S) | 8921912270 |
Receives reassigned benefits from 28 practitioners Practice locations: Flowood, MS; Jackson, MS |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician |
208100000X | 43-278 | MS | Yes |
Addresses
Primary practice location
1350 E Woodrow Wilson Ave
Jackson, MS 39216-5112
Mailing address
1350 E Woodrow Wilson Ave
Jackson, MS 39216-5112
Phone (601) 981-2611
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 08420277 | Medicaid | MS |
Other names
- Methodist Rehab Center
Other providers in Jackson, MS
- Mississippi Homecare of Jackson, LLC
- Mississippi Hospital for Restorative Care, Inc.
- Mississippi Infusion Services LLC
- Mississippi Maternal-Fetal Medicine, P.a.
- Mississippi Medical, Inc
- Mississippi Methodist Hospital & Rehabilitation Center, Inc.
- Mississippi Methodist Hospital & Rehabilitation Center, Inc.
- Mississippi Neurological Institute LLC
- Mississippi Oncology Associates
- Mississippi Pain Management
All providers in Jackson, MS · Physical Medicine & Rehabilitation Physician in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 15, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.