ELITE PERFORMANCE AND REHAB, LLC (NPI# 1255877346) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255877346 |
| Entity Type | Organization |
| Organization Name | ELITE PERFORMANCE AND REHAB, LLC |
| Practice Address |
1901 A Mission 66 Vicksburg MS 39180 |
| Practice Telephone | 6016360097 |
| Mailing Telephone | 6016360097 |
| Enumeration Date | 2017-01-12 |
| Last Update Date | 2017-01-12 |
| Authorized Official Name | WILLIAM FULCHER JR. (PARTNER) |
| Authorized Official Telephone | 6016360097 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
Ambulatory Health Care Facilities |
| Street Address |
1901 A MISSION 66 |
| City | VICKSBURG |
| State | MS |
| Zip Code | 39180 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679931083 | Heather M Anderson | Physician Assistant | 2080 S Frontage Rd Ste 100, Vicksburg, MS 39180 | 2016-02-01 |
| 1245604941 | Warren County Assn.for Retarded Citizens, Inc. | Day Training, Developmentally Disabled Services | 100 Smokey Lane, Vicksburg, MS 39180 | 2015-11-18 |
| 1386012904 | Brian Oliver Snowden | Counselor | 3530 Manor Dr Ste 5a, Vicksburg, MS 39180 | 2015-09-14 |
| 1962802710 | Jordan P. Crocker, D.m.d., Pllc | Clinic/Center | 109 Monument Place, Vicksburg, MS 39180 | 2014-08-29 |
| 1821434259 | Trisha Addison | Physical Therapist | 2222 South Frontage Road, Suite D, Vicksburg, MS 39180 | 2013-05-13 |
| 1073862157 | Laura Jeanne Briggs | Physical Therapist | 1901-a Mission 66, Vicksburg, MS 39180 | 2012-09-05 |
| 1912175258 | Andrea T. Harris | Counselor | Warren-yazoo Mental Health Service, 3444 Wisconsin Ave., Vicksburg, MS 39180 | 2008-02-20 |
| 1922217314 | Austin Family Dentistry | Dentist | 3040 Indiana Ave, Vicksburg, MS 39180 | 2007-05-22 |
| 1063539138 | Ollie Hardaway Jr. | Dentist | 154 Cottonwood Street, Vicksburg, MS 39180 | 2007-03-23 |
| 1740353408 | Ballard Dental Group | Dentist | 3040 Indiana Avenue, Vicksburg, MS 39180 | 2006-11-17 |
| Find all providers in zip 39180 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336291749 | Freeman Physical Therapy Inc. | Clinic/Center | 1901a Mission 66, Vicksburg, MS 39180-3711 | 2007-01-17 |
| 1619351517 | Freeman Physical Therapy | Clinic/Center | 1990 S Frontage Rd, Suite J, Vicksburg, MS 39180-5232 | 2015-07-10 |
| 1598039976 | Scott Robbins Physical Therapy, PC | Clinic/Center | 2222 S Frontage Rd, Suite D, Vicksburg, MS 39180-5271 | 2012-03-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841804283 | Rehab Ready, LLC | Clinic/Center | 2136 Stateline Rd W Ste B-c, Southaven, MS 38671-1210 | 2020-09-02 |
| 1609411354 | Enduracare Acute Care Services LLC | Clinic/Center | 351 Old Oak Cir, Pontotoc, MS 38863-5016 | 2019-11-16 |
| 1154880540 | Core Rehabilitation, LLC | Clinic/Center | 143c Willowbrook Dr, Saltillo, MS 38866-6896 | 2019-03-15 |
| 1952877060 | Encore Rehabilitation Inc | Clinic/Center | 5731 Highway 45 Alt S Ste 1277, West Point, MS 39773-0414 | 2018-10-16 |
| 1689150054 | 5 Star Performance Center, LLC | Clinic/Center | 4500 Lakeland Dr, Flowood, MS 39232-9583 | 2018-07-18 |
| 1134633324 | Enduracare Acute Care Services LLC | Clinic/Center | 236 North Caldwell Drive, Hazelhurst, MS 39083 | 2017-11-27 |
| 1104330430 | Enduracare Acute Care Services LLC | Clinic/Center | 7381 S Siwell Rd Ste A, Byram, MS 39272-8741 | 2017-11-22 |
| 1972016848 | 2083 Therapy, LLC | Clinic/Center | 5080 Lakeland Dr., Suite B, Flowood, MS 39232-4403 | 2017-11-14 |
| 1801309778 | 2083 Therapy, LLC | Clinic/Center | 1392 W Government St Ste C, Brandon, MS 39042-3049 | 2017-11-14 |
| 1689185597 | Southern Physical and Aquatic Therapy, P.a. | Clinic/Center | 369 Peoples Drive, Pontotoc, MS 38863 | 2017-10-18 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.