NPIMap

Organization Active NPI

Sentry Rehab, LLC

  • Rehabilitation Clinic/Center
  • Brandon, MS
National Provider Identifier
1881015147
Registry record updated Jan 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
SENTRY REHAB, LLC
Practice address
106A Office Park Dr
Brandon, MS 39042-2404
Phone
(601) 824-9010
Fax
(601) 824-9044
NPI assigned
Jan 3, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2014

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

Authorized official

Name
Mr. Cameron Dirk Goddard
Title
Ar Manager
Phone
(601) 824-9010

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X Primary

Addresses

Primary practice location

106A Office Park Dr
Brandon, MS 39042-2404

Mailing address

106A Office Park Dr
Brandon, MS 39042-2404
Phone (601) 824-9010

National Provider Directory

National Provider Directory
Tax ID family
Sentry Rehab LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

106A Office Park Dr
Brandon, MS 39042
Phone (601) 824-9010

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1388707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388707200000",
    "number": "1881015147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106A OFFICE PARK DR",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390422404",
            "telephone_number": "601-824-9010",
            "fax_number": "601-824-9044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106A OFFICE PARK DR",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390422404",
            "telephone_number": "601-824-9010",
            "fax_number": "601-824-9044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENTRY REHAB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-03",
        "last_updated": "2014-01-03",
        "status": "A",
        "authorized_official_last_name": "GODDARD",
        "authorized_official_first_name": "CAMERON",
        "authorized_official_middle_name": "DIRK",
        "authorized_official_title_or_position": "AR MANAGER",
        "authorized_official_telephone_number": "601-824-9010",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2014; 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.