Mississippi Sport and Spine Rehabilitation

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

MISSISSIPPI SPORT AND SPINE REHABILITATION

Practice address

1743 Cliff Gookin Blvd
Tupelo, MS 38801-6723

Phone

(662) 680-5216

Fax

(662) 680-5217

NPI assigned

Nov 10, 2006

Last updated

Oct 20, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Chad Barker, ATNPI 1881602449

Title

Athletic Trainer

Phone

(662) 680-5216

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Chad Barker, ATC

  • Athletic Trainer
  • Tupelo, MS
  • NPI 1881602449
  Authorized official Same address or phone

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224460800000",
    "number": "1952472219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1743 CLIFF GOOKIN BLVD",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388016723",
            "telephone_number": "662-680-5216",
            "fax_number": "662-680-5217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1743 CLIFF GOOKIN BLVD",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388016723",
            "telephone_number": "662-680-5216",
            "fax_number": "662-680-5217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSISSIPPI SPORT AND SPINE REHABILITATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-10",
        "last_updated": "2008-10-20",
        "status": "A",
        "authorized_official_last_name": "BARKER",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "ATHLETIC TRAINER",
        "authorized_official_telephone_number": "662-680-5216",
        "authorized_official_credential": "AT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09015485",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mississippi CVS Pharmacy LLC (CVS Pharmacy #17968)
• Mississippi CVS Pharmacy, L.L.C. (CVS Pharmacy #08992)
• Mississippi Methodist Hospital & Rehabilitation Center, Inc.
• Mississippi Pediatric Endocrine Care PLLC (MS Pediatric Endocrine Care)
• Mississippi Senior Care
• Mississippi State Department of Health
• Alison Renee Mitchell
• Janice Mitchell, DO
• Kristin Mitchell, M.D.
• Mary Ellen Mitchell, MSN,FNP

• Physical Therapist in Tupelo, MS
• Providers in Tupelo, MS by specialty
• Physical Therapist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 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.