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JACKSON REHAB AND WELLNESS CENTER NPI 1285792010


NPI Information

NPI: 1285792010
Provider Name: JACKSON REHAB AND WELLNESS CENTER
Classification: Physical Therapist - 2251C2600X
Entity Type: Organization

Specialization: Cardiopulmonary

Address:
5380 I-55 N
SUITE 101
JACKSON, MS
ZIP 39211
Phone: (601) 316-8800
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JACKSON REHAB AND WELLNESS CENTER is a cardiopulmonary physical therapist in Jackson, MS. The provider is a licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Cardiovascular & Pulmonary Physical Therapy, who has demonstrated specialized knowledge and skill in cardiovascular and pulmonary anatomy and physiology medicine, rehabilitation, critical care, and emergency and trauma. JACKSON REHAB AND WELLNESS CENTER NPI is 1285792010. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

5380 I-55 N
SUITE 101
JACKSON, MS
ZIP 39211
Phone: (601) 316-8800
Fax: (601) 899-5198

The provider's authorized official is Michael Kirtley .
The authorized official title is Director and has the following contact phone number (601) 316-8800.

The enumeration date for this NPI number is 12/5/2006 and was last updated on 7/21/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12251C2600XPhysical TherapistCardiopulmonaryMISSISSIPPIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1C02912OTHERMISSISSIPPIMEDICARE PART B

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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