NPIMap

Organization Active NPI

Community Rehab of Greenville Inc

  • Physical Therapy Clinic/Center
  • Saint Louis, MO
National Provider Identifier
1801984810
Registry record updated Jul 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
NONE REQUIRED Issued in MO
Legal business name
COMMUNITY REHAB OF GREENVILLE INC
Practice address
3808 S Lindbergh Blvd
Suite 105
Saint Louis, MO 63127-1367
Phone
(314) 843-7800
Fax
(314) 843-7804
NPI assigned
Oct 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2008

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

Authorized official

Name
Ms. Melanie L Fayard, P.T.
Title
Vice President
Phone
(228) 436-0999

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X
Physical Therapy Clinic/Center 261QP2000X NONE REQUIRED MO Primary

Addresses

Primary practice location

3808 S Lindbergh Blvd
Suite 105
Saint Louis, MO 63127-1367

Mailing address

PO Box 7066
Gulfport, MS 39506-7066
Phone (228) 436-0999

Other identifiers 2

IdentifierTypeStateIssuer
186721OtherMOBCBS GROUP PROVIDER NUMBE
656018OtherMOHEALTHLINK GROUP PROVIDER

Other names 1

  • PIONEER SPORTS MEDICINE & PHYSICAL THERAPY Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214956800000",
    "number": "1801984810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7066",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395067066",
            "telephone_number": "228-436-0999",
            "fax_number": "228-436-0990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3808 S LINDBERGH BLVD",
            "address_2": "SUITE 105",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631271367",
            "telephone_number": "314-843-7800",
            "fax_number": "314-843-7804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY REHAB OF GREENVILLE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2008-07-02",
        "status": "A",
        "authorized_official_last_name": "FAYARD",
        "authorized_official_first_name": "MELANIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "228-436-0999",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MO",
            "license": "NONE REQUIRED",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP PROVIDER NUMBE",
            "identifier": "186721",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK GROUP PROVIDER",
            "identifier": "656018",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PIONEER SPORTS MEDICINE & PHYSICAL THERAPY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2008; 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.