NPIMap

Organization Active NPI

Tri-Vista Rehab, Inc.

  • Physical Therapy Clinic/Center
  • Vestavia, AL
National Provider Identifier
1942581277
Registry record updated Aug 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
1011705 Issued in MS
Legal business name
TRI-VISTA REHAB, INC.
Practice address
3776 Crosshaven Dr
Vestavia, AL 35223-2833
Phone
(337) 886-7097
Fax
(866) 522-1008
NPI assigned
Aug 31, 2011
Last updated
Aug 31, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2011

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

Authorized official

Name
Mr. Kevin Troy Boutin, OTRNPI 1780740456
Title
President
Phone
(662) 840-0535

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 1011705 MS Primary

Addresses

Primary practice location

3776 Crosshaven Dr
Vestavia, AL 35223-2833

Mailing address

PO Box 3592
Tupelo, MS 38803-3592
Phone (662) 840-0535

National Provider Directory

National Provider Directory
Tax ID family
Trivista Rehab Inc8 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.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1314748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314748800000",
    "number": "1942581277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3592",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388033592",
            "telephone_number": "662-840-0535",
            "fax_number": "662-842-7915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3776 CROSSHAVEN DR",
            "city": "VESTAVIA",
            "state": "AL",
            "postal_code": "352232833",
            "telephone_number": "337-886-7097",
            "fax_number": "866-522-1008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-VISTA REHAB, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-31",
        "last_updated": "2011-08-31",
        "status": "A",
        "authorized_official_last_name": "BOUTIN",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "TROY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "662-840-0535",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OTR"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MS",
            "license": "1011705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vestavia, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 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.