ADVANCED MEDICAL REHABILITATION, LLC (NPI# 1831132562) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831132562 |
| Entity Type | Organization |
| Organization Name | ADVANCED MEDICAL REHABILITATION, LLC |
| Practice Address |
1051 Lee Dr Suite 1b Clarksdale MS 38614-3615 |
| Mailing Address |
1051 Lee Drive Suite 1b Clarksdale MS 38614-3616 |
| Practice Telephone | 6626242466 |
| Practice Fax Number | 6626244876 |
| Mailing Telephone | 6626242466 |
| Mailing Fax Number | 6626244876 |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. JOHN C. BERRY (OWNER) |
| Authorized Official Telephone | 6626242466 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
R659975 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1051 LEE DR SUITE 1B |
| City | CLARKSDALE |
| State | MS |
| Zip Code | 38614-3615 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386265627 | Lillie Mae Lockett | Technician | 1025 Ritchie Ave, Clarksdale, MS 38614 | 2020-04-28 |
| 1063957751 | Autospa-healthy Youth Center | Nurse Practitioner | 1202 Desoto Ave, Suite A, Clarksdale, MS 38614 | 2017-01-04 |
| 1700226123 | Nikki Nikkia Cager | Internal Medicine | 785 Ohio Ave Ste 2d, Clarksdale, MS 38614 | 2013-06-29 |
| 1205186947 | Celestial Comfort Care Hospice | Hospice Care, Community Based | 110 Yazoo Ave. Suite 212, Clarksdale, MS 38614 | 2012-09-10 |
| 1063667129 | The Smile Center of Clarksdale | Clinic/Center | 526 Choctaw Street, Suites B & C, Clarksdale, MS 38614 | 2008-11-17 |
| 1801060033 | Clarksdale Municipal School District | Local Education Agency (LEA) | Gycelle Tynes Educational Center, Friars Point Road, Clarksdale, MS 38614 | 2008-04-18 |
| 1184806150 | Mary A Williams | Nurse Practitioner | 125 Highway 322, Clarksdale, MS 38614 | 2007-12-03 |
| 1114040367 | William F Wilson Jr. | Dentist | 850 Desoto Ave, Extended, Clarksdale, MS 38614 | 2007-04-10 |
| 1952434920 | Kathleen Tinnel | Nurse Practitioner | 2245 N State St, Clarksdale, MS 38614 | 2007-03-13 |
| 1497888457 | Carole L Mangrem | Pediatrics | 2245 N Starte St, Clarksdale, MS 38614 | 2007-03-13 |
| Find all providers in zip 38614 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063957751 | Autospa-healthy Youth Center | Nurse Practitioner | 1202 Desoto Ave, Suite A, Clarksdale, MS 38614 | 2017-01-04 |
| 1184806150 | Mary A Williams | Nurse Practitioner | 125 Highway 322, Clarksdale, MS 38614 | 2007-12-03 |
| 1376752832 | Dallas Maxwell Earnest | Nurse Practitioner | 1015 Lee Dr Ste 13, Clarksdale, MS 38614-3619 | 2007-05-22 |
| 1447251632 | Pamela Wilson | Nurse Practitioner | 860 Desoto Ext, Clarksdale, MS 38614 | 2005-08-10 |
| 1659370229 | Patricia White | Nurse Practitioner | 2245 North State Street, Clarksdale, MS 38614-7202 | 2005-07-18 |
| 1366042277 | Sylvester Lewis Thornton | Nurse Practitioner | 1970 Hospital Dr, Clarksdale, MS 38614-7202 | 2020-10-29 |
| 1225642473 | Tammy Sherrell Campbell | Nurse Practitioner | 619 S State St, Clarksdale, MS 38614-6319 | 2020-09-04 |
| 1841817707 | Kristalin Young Presley | Nurse Practitioner | 125 Highway 322, Clarksdale, MS 38614-4620 | 2020-06-26 |
| 1407487069 | Leah Lamb Rybolt | Nurse Practitioner | 1970 Hospital Dr, Clarksdale, MS 38614-7202 | 2020-01-31 |
| 1780157727 | Megan Green Carpenter | Nurse Practitioner | 551 Medical Dr, Clarksdale, MS 38614-6733 | 2019-01-02 |
| Find all providers in CLARKSDALE | ||||
| City | CLARKSDALE |
| Zip Code | 38614 |
Please comment or provide details below to improve the information on ADVANCED MEDICAL REHABILITATION, LLC.
| 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.