Individual provider Active NPI

Beth R Breland, DPT

  • Physical Therapist
  • Gulfport, MS
National Provider Identifier
1811242589
Registry record updated Oct 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT5132 Issued in MS
Practice address
15476 Dedeaux Rd Ste a
Gulfport, MS 39503-2637
Phone
(228) 215-0700
NPI assigned
Jul 19, 2012
Last updated
Oct 22, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT5132 MS Primary

Addresses

Primary practice location

15476 Dedeaux Rd Ste a
Gulfport, MS 39503-2637

Mailing address

6300 E Lake Blvd Ste 301
Vancleave, MS 39565-6771
Phone (228) 230-2663

Other practice location 1

411 W North St
Poplarville, MS 39470-2203
Phone (601) 795-2130

Other identifiers 2

IdentifierTypeStateIssuer
09015077MedicaidMS
1033218524OtherMSGROUP NPI

Other names 1

  • Beth Rogers Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141118000680 MS Practitioner - Physical Therapist in Private Practice 0042432502 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bienville Therapy, LLCGroup PAC ID 1254878325, 24 clinicians

Practice addresses (Care Compare)

15476 Dedeaux Rd
Suite a
Gulfport, MS 39503-2637
Phone (228) 215-0700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT5132MSMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Encore Rehabilitation, Inc. Physical Therapist CurrentSince Aug 6, 2014 Accepting new patients
Encore Rehabilitation, Inc. Physical Therapist CurrentSince Aug 6, 2014 Accepting new patients
Bienville Therapy, LLC Physical Therapist CurrentSince Sep 9, 2025 Accepting new patients
Bienville Therapy, LLC Physical Therapist CurrentSince Sep 9, 2025 Accepting new patients
Encore Rehabilitation Inc Past Accepting new patients
Encore Rehabilitation Inc Physical Therapist Past Accepting new patients
Encore Rehabilitation Inc Physical Therapist Past Accepting new patients
Encore Rehabilitation Inc Physical Therapist Past Accepting new patients
Encore Rehabilitation Inc Physical Therapist Past Accepting new patients
Encore Rehabilitation Inc Physical Therapist Past Accepting new patients
Encore Rehabilitation Inc Physical Therapist Past Accepting new patients
Encore Rehabiliation Inc Physical Therapist Past Accepting new patients
Encore Rehabilitation Inc Physical Therapist Past Accepting new patients
Encore Rehabilitation Inc Past Accepting new patients
Encore Rehabilitation Inc Physical Therapist Past Accepting new patients
Encore Rehabilitation Inc Physical Therapist Past Accepting new patients
Encore Rehabilitation Inc Past Accepting new patients

Locations

251 Johnston St SE
Ste 300
Decatur, AL 35601
Phone (256) 340-9708

15476 Dedeaux Rd
#A
Gulfport, MS 39503
Phone (228) 215-0700

433 Main St
Leakesville, MS 39451
Phone (601) 394-4545

411 W North St
Poplarville, MS 39470
Phone (601) 795-2130

6300 E Lake Blvd
Ste 101
Vancleave, MS 39565
Phone (228) 215-2240

6300 E Lake Blvd
Ste 301
Vancleave, MS 39565

Organizations & group practices 17

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1342656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761091200000",
    "number": "1811242589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6300 E LAKE BLVD STE 301",
            "city": "VANCLEAVE",
            "state": "MS",
            "postal_code": "395656771",
            "telephone_number": "228-230-2663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15476 DEDEAUX RD STE A",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395032637",
            "telephone_number": "228-215-0700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "411 W North St",
            "address_purpose": "LOCATION",
            "city": "Poplarville",
            "state": "MS",
            "postal_code": "394702203",
            "country_code": "US",
            "telephone_number": "601-795-2130",
            "fax_number": "601-795-2164",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRELAND",
        "first_name": "BETH",
        "middle_name": "R",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-19",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT5132",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09015077",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1033218524",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BETH",
            "last_name": "ROGERS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Gulfport, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.