Provider Demographics
NPI:1811105463
Name:PIERCE, RHONDA (PT)
Entity type:Individual
Prefix:
First Name:RHONDA
Middle Name:
Last Name:PIERCE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8419
Mailing Address - Street 2:
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39535-8087
Mailing Address - Country:US
Mailing Address - Phone:228-388-5714
Mailing Address - Fax:228-388-0017
Practice Address - Street 1:2210 MILL STREET EXT STE B
Practice Address - Street 2:
Practice Address - City:LUCEDALE
Practice Address - State:MS
Practice Address - Zip Code:39452-6079
Practice Address - Country:US
Practice Address - Phone:601-947-9005
Practice Address - Fax:301-947-9007
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH4773225100000X
FLPT28222225100000X
MSPT4492225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS1033218524OtherGROUP NPI
AL1003819608OtherGROUP NPI
ALK531OtherGROUP MEDICARE
MS09015077Medicaid
AL529917620OtherGROUP MEDICAID
MS1033218524OtherGROUP NPI
MSC02726Medicare PIN