Triumph Rehabilitation and Sports Therapy Clinic, LLC

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Legal business name

TRIUMPH REHABILITATION AND SPORTS THERAPY CLINIC, LLC

Doing business as

TRIUMPH Rehabilitation / Sports Injuries Clinic

Practice address

350 Desiard Plaza Dr
Monroe, LA 71203-4959

Phone

(318) 343-1870

Fax

(318) 345-2862

NPI assigned

Jun 5, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Vernon Moss, OTNPI 1912123480

Title

Owner

Phone

(318) 343-1870

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• TRIUMPH Rehabilitation / Sports Injuries Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Locations

Practitioners 1

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

• Vernon Moss, LOTR

  • Occupational Therapist
  • Monroe, LA
  • NPI 1912123480
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1338854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688515200000",
    "number": "1801157052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9144",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712119144",
            "telephone_number": "318-343-1870",
            "fax_number": "318-345-2862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 DESIARD PLAZA DR",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712034959",
            "telephone_number": "318-343-1870",
            "fax_number": "318-345-2862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIUMPH REHABILITATION AND SPORTS THERAPY CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-05",
        "last_updated": "2023-07-05",
        "certification_date": "2023-07-05",
        "status": "A",
        "authorized_official_last_name": "MOSS",
        "authorized_official_first_name": "VERNON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "318-343-1870",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OT"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1434957",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TRIUMPH Rehabilitation / Sports Injuries Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Occupational Therapist in Monroe, LA
• Providers in Monroe, LA by specialty
• Occupational Therapist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2023; 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.