JEFFERSON COUNTY NURSING HOME THERAPY — NPI 1356772594 (Licensed & Credentialed Hospitals

CMS-1500 Box 24J / 33a • NPI

1356772594

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

283X00000X (CMS A0[7])

Licensed & Credentialed Hospitals — Rehabilitation Hospital

Box 32 Service Location & ZIP+4

910 MAIN ST, FAYETTE, MS, 39069

Official NPPES Practice Location

Practice Phone & Referral Fax

(601) 786-3888

Fax: (601) 786-9400

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1356772594 (JEFFERSON COUNTY NURSING HOME THERAPY) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1356772594` (NPI-2 Organization / Facility)
Provider / Legal Name	JEFFERSON COUNTY NURSING HOME THERAPY
Plain-English Specialty	Licensed & Credentialed Hospitals — Rehabilitation Hospital NUCC Code: `283X00000X` (Rehabilitation Hospital)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	910 MAIN ST, FAYETTE, MS, 39069
Practice Telephone / Fax	Tel: (601) 786-3888 \| Fax: (601) 786-9400
Administrative Mailing Address	P.O. BOX 1089, FAYETTE, MS, 39069
Enumeration & Last Sync	Enumerated: 2013-12-12 \| CMS Record Updated: 2013-12-12
Authorized Official	MONTINA FLETCHER-LEWIS (Administrator)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

910 MAIN ST, FAYETTE, MS, 39069

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Plain-English Taxonomy & CMS Crosswalk (283X00000X)

What Does Taxonomy Code 283X00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 283X00000X translates to:
"Licensed & Credentialed Hospitals — Rehabilitation Hospital"

CMS-1500 Medicare Specialty Crosswalk: CMS Code A0[7] (Hospital-Rehabilitation (PPS excluded))
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Rehabilitation Hospital for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (JEFFERSON COUNTY NURSING HOME THERAPY)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`283X00000X` — Rehabilitation Hospital Plain English: Licensed & Credentialed Hospitals — Rehabilitation Hospital	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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JEFFERSON COUNTY NURSING HOME THERAPY (NPI #1356772594)