RIDGELAND SPORTS MEDICINE & REHAB, INC (NPI# 1871689851) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871689851 |
| Entity Type | Organization |
| Organization Name | RIDGELAND SPORTS MEDICINE & REHAB, INC |
| Practice Address |
665 S Pear Orchard Rd Suite 114 Ridgeland MS 39157-4861 |
| Practice Telephone | 6019561211 |
| Practice Fax Number | 6019562282 |
| Mailing Telephone | 6019561211 |
| Mailing Fax Number | 6019562282 |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. MICHELLE C ELLISON (PRESIDENT/OWNER) |
| Authorized Official Telephone | 6019561211 |
| Authorized Official Credential | P. T. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
MS PT0747 | MS | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | AETNA | 5965404 | 01 |
| Street Address |
665 S PEAR ORCHARD RD SUITE 114 |
| City | RIDGELAND |
| State | MS |
| Zip Code | 39157-4861 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083062889 | Speech Depot | Speech-Language Pathologist | 665 S Pear Orchard Rd, Suite 106-185, Ridgeland, MS 39157-4861 | 2016-06-02 |
| 1952614414 | Medicomp Physical Therapy Ridgeland, Inc. | Occupational Therapist | 665 S Pear Orchard Rd, Suite 114, Ridgeland, MS 39157-4861 | 2010-07-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124631023 | Mychell Thomas | Licensed Practical Nurse | 199 Charmant Place, Ridgeland, MS 39157 | 2020-08-28 |
| 1225680945 | Verthena Edwards | Home Health | 301 Pinehurst Cir, N/a, Ridgeland, MS 39157 | 2019-07-12 |
| 1730663469 | Essential Touchtones | Psychologist | 210 W. Jackson Street, Ridgeland, MS 39157 | 2018-09-19 |
| 1841786365 | Whitney Paige Crum | Speech-Language Pathologist | Laskin Therapy Group Pa, 207 W Jackson St, Ridgeland, MS 39157 | 2018-07-09 |
| 1811487002 | Camille Brockett | Social Worker | 270 Trace Colony Park Dr Ste B, Ridgeland, MS 39157 | 2018-05-14 |
| 1588171177 | Layson Counseling Group, Pllc | Counselor | 573 Hwy 51 Suite B, Ridgeland, MS 39157 | 2018-01-04 |
| 1407376452 | Mobility Rehab LLC | Clinic/Center | 745 S Pear Orchard Road, Apt 335, Ridgeland, MS 39157 | 2017-06-21 |
| 1184165102 | Sinus and Allergy Institute Pllc | Otolaryngology | 1115 Highland Colony Parkway, Suite C, Ridgeland, MS 39157 | 2017-03-09 |
| 1093263410 | Natural Health Project LLC | General Practice | 555 Highway 51, Ridgeland, MS 39157 | 2016-09-14 |
| 1851755714 | Jerlunda Lynn Dudley | Social Worker | 511 Clark Street, Rosedale, MS 39157 | 2016-04-07 |
| Find all providers in zip 39157 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821410150 | Home Aide Therapy Services LLC | Clinic/Center | 149 Riverwalk Blvd Ste 6, Ridgeland, SC 29936-8191 | 2014-01-06 |
| 1184768376 | Genesis Pt and Rehab Services | Clinic/Center | 227 Hwy 51, Ridgeland, MS 39157-4425 | 2007-02-19 |
| 1871143024 | Mobility Rehab LLC - Chateau Ridgeland | Clinic/Center | 745 S Pear Orchard Rd Apt 335, Ridgeland, MS 39157-5143 | 2019-09-18 |
| 1891140711 | Agilitas Usa, Inc. | Clinic/Center | 1000 Highland Colony Pkwy Ste 2002, Ridgeland, MS 39157-2075 | 2016-04-28 |
| 1952793309 | Head To Toe Physical Therapy | Clinic/Center | 665 S Pear Orchard Rd Ste 114, Ridgeland, MS 39157-4859 | 2015-02-23 |
| 1417280009 | Mid South Rehab Outpatient Clinic LLC | Clinic/Center | 711 Avignon Dr, Ridgeland, MS 39157-5120 | 2009-09-14 |
| 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 | ||||
Please comment or provide details below to improve the information on RIDGELAND SPORTS MEDICINE & REHAB, INC.
| 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.