NPIMap

Organization Active NPI

Professional Rehabilitation Services

  • Chiropractor
  • Purvis, MS
National Provider Identifier
1801079249
Registry record updated Dec 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
998 Issued in MS
Legal business name
PROFESSIONAL REHABILITATION SERVICES
Practice address
105 Main St.
Purvis, MS 39475
Phone
(601) 794-0081
Fax
(601) 794-0083
NPI assigned
Dec 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2007

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

Authorized official

Name
Dr. John Robert Acord Jr., DCNPI 1417041252
Title
Doctor
Phone
(601) 794-0081

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 998 MS Primary

Addresses

Primary practice location

105 Main St.
Purvis, MS 39475

Mailing address

PO Box 1863
Purvis, MS 39475-1863
Phone (601) 794-0081

Other identifiers 1

IdentifierTypeStateIssuer
09015049MedicaidMS

Other names 1

  • Purvis Chiropractic Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110128000501 MS Part B Supplier - Clinic/Group Practice 0749469351 Receives reassigned benefits from 1 practitioner
Practice locations: Purvis, MS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1196985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196985600000",
    "number": "1801079249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1863",
            "city": "PURVIS",
            "state": "MS",
            "postal_code": "394751863",
            "telephone_number": "601-794-0081",
            "fax_number": "601-794-0083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 MAIN ST.",
            "city": "PURVIS",
            "state": "MS",
            "postal_code": "39475",
            "telephone_number": "601-794-0081",
            "fax_number": "601-794-0083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL REHABILITATION SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-07",
        "last_updated": "2007-12-07",
        "status": "A",
        "authorized_official_last_name": "ACORD",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "601-794-0081",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MS",
            "license": "998",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09015049",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Purvis Chiropractic Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Purvis, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.