NPIMap

Organization Active NPI

Trivista

  • Assisted Living Facility
  • Corinth, MS
National Provider Identifier
1831473453
Registry record updated Sep 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
OT2627 Issued in MS
Legal business name
TRIVISTA
Practice address
164 CR 512
Corinth, MS 38834
Phone
(901) 412-6441
NPI assigned
Sep 30, 2011
Last updated
Sep 30, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2011

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

Authorized official

Name
Ms. Mallory Parks, OTR/L
Title
Occupational Therapist
Phone
(901) 412-6441

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X OT2627 MS Primary

Addresses

Primary practice location

164 CR 512
Corinth, MS 38834

Mailing address

164 County Road 512
Corinth, MS 38834-8125
Phone (901) 412-6441

National Provider Directory

National Provider Directory
Tax ID family
Trivista8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1317340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317340800000",
    "number": "1831473453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "164 COUNTY ROAD 512",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388348125",
            "telephone_number": "901-412-6441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "164 CR 512",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "38834",
            "telephone_number": "901-412-6441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIVISTA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-30",
        "last_updated": "2011-09-30",
        "status": "A",
        "authorized_official_last_name": "PARKS",
        "authorized_official_first_name": "MALLORY",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "901-412-6441",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MS",
            "license": "OT2627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corinth, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2011; 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.