MEDICARE: REGIONAL REHABILITATION CENTER, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	261QP2000X	Physical Therapy Clinic/Center
2	261QR0400X	Rehabilitation Clinic/Center
3	261QP3300X	Pain Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013115005
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REGIONAL REHABILITATION CENTER, PLLC

Provider Business Mailing Address
First Line	:	6290 MANCHESTER HWY
Second Line	:
City	:	MORRISON
State	:	TN
Zip	:	37357-7589
Country	:	US
Telephone Number	:	931-815-1616
Fax Number	:

Provider Business Practice Location Address
First Line	:	6290 MANCHESTER HWY
Second Line	:
City	:	MORRISON
State	:	TN
Zip	:	37357-7589
Country	:	US
Telephone Number	:	931-815-1616
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	SAM NUTHALAPATY
Credential	:
Telephone Number	:	931-815-1616

Provider Enumeration Date	:	07/11/2007
Last Update Date	:	04/02/2019

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