Professional Rehab

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

4344 Issued in TN

Legal business name

PROFESSIONAL REHAB

Practice address

6231 Ravenwood CV
Horn Lake, MS 38637-2588

Phone

(901) 438-8799

Fax

(662) 280-3324

NPI assigned

Aug 30, 2006

Organization subpart

No

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

Authorized official

Name

Jacqueline Rueda, PT.NPI 1710910187

Title

Physical Therapist/President

Phone

(901) 438-8799

Specialties & licenses 1

Addresses

Practitioners 1

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

• Jacqueline Rueda, PT.

  • Physical Therapist
  • Horn Lake, MS
  • NPI 1710910187
  NPD (past) Authorized official

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1801906045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6231 RAVENWOOD CV",
            "city": "HORN LAKE",
            "state": "MS",
            "postal_code": "386372588",
            "telephone_number": "901-438-8799",
            "fax_number": "662-280-3324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6231 RAVENWOOD CV",
            "city": "HORN LAKE",
            "state": "MS",
            "postal_code": "386372588",
            "telephone_number": "901-438-8799",
            "fax_number": "662-280-3324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL REHAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RUEDA",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST/PRESIDENT",
        "authorized_official_telephone_number": "901-438-8799",
        "authorized_official_credential": "PT."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "4344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Virginia Grace Piercy, MS, CHES
• PLG Resource Agency
• Amelia Plumlee, M.S. CCC-SLP
• Tiffany Poole, M.S.
• Chelsea Prince
• Psychological Education Inc
• Psychological Education Inc
• Psychological Education Incorporated
• Psychosocial Boutique, PLLC.
• Tiffany Shannon Ray, CRNA

• Physical Therapist in Horn Lake, MS
• Providers in Horn Lake, MS by specialty
• Physical Therapist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.