ELITE PERFORMANCE AND REHAB, LLC
NPI 1255877346
Clinic/Center - Physical Therapy in Vicksburg, MS

Active since January 12, 2017
1901 A MISSION 66, VICKSBURG, MS 39180(601) 636-0097 Get Directions Write a Review

NPPES record last updated: July 18, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 18, 2022, Jan 12, 2017 (2 updates tracked since 2017).

About Elite Performance And Rehab, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ELITE PERFORMANCE AND REHAB, LLC (NPI 1255877346) is a healthcare organization registered as a physical therapy in Vicksburg, Mississippi and active in the NPI registry since January 2017. The organization lists William Fulcher, Partner, as its authorized official.

NPPES Registry Identity

NPI1255877346
Entity TypeOrganization
Primary Taxonomy261QP2000X
Legal Business NameELITE PERFORMANCE AND REHAB, LLC
Location Address1901 A MISSION 66Vicksburg, MS 39180
Mailing Address1901 A Mission 66Vicksburg, MS 39180 · (601) 636-0097
Organization SubpartNo
Authorized OfficialWilliam FulcherPartner · (601) 636-0097
Enumeration DateJanuary 12, 2017
Last NPPES UpdateJuly 18, 20222 updates tracked since enumeration
NPPES CertifiedJuly 18, 2022
✔ NPI 1255877346 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Physical TherapyAmbulatory Health Care Facilities
Taxonomy Code261QP2000X
Definition
An entity, facility, or distinct part of a facility providing diagnostic and treatment services related to physical rehabilitation. Physical therapy is a dynamic profession with an established theoretical and scientific base and widespread clinical applications in the restoration, maintenance, and promotion of optimal physical function. Physical therapists and physical therapist assistants are licensed health care professionals who are experts in the movement system and help individuals maintain, restore, and improve movement, activity, and functioning, thereby enabling optimal performance and enhancing health, well-being, and quality of life. Their services prevent, minimize, or eliminate impairments of body functions and structures, activity limitations, and participation restrictions. Physical therapy is provided for individuals of all ages who have or may develop impairments, activity limitations, and participation restrictions related to (1) conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems or (2) the negative effects attributable to unique personal and environmental factors as they relate to human performance.
1901 A MISSION 66, Vicksburg, MS 39180

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Elite Performance And Rehab, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

11

Medicare enrollment records show 11 clinicians reassign Medicare billing to Elite Performance And Rehab, LLC, which bills Medicare for the services they deliver. Of these, 6 practice at this address and 8 within 10 miles. They are listed nearest first.

Clinicians by Medicare Specialty 3

Physical Therapist in Private Practice7
Occupational Therapist in Private Practice2
Qualified Speech Language Pathologist2

Clinicians, nearest first (11)

Physical Therapist in Private Practice
NPI 1215670112
1901A MISSION 66
Vicksburg, MS 39180
(601) 638-5518
Same address
Qualified Speech Language Pathologist
NPI 1497834287
1901 MISSION 66 SUITE A
Vicksburg, MS 39180
(601) 638-4076
Same address
Physical Therapist in Private Practice
NPI 1588117956
1901A MISSION 66
Vicksburg, MS 39180
(601) 638-5518
✔ Accepts MedicareSame address
Physical Therapist in Private Practice
NPI 1881147247
1901A MISSION 66
Vicksburg, MS 39180
(601) 638-5518
✔ Accepts MedicareSame address
Physical Therapist in Private Practice
NPI 1710441308
1901A MISSION 66
Vicksburg, MS 39180
(601) 638-5518
✔ Accepts MedicareSame address
Physical Therapist in Private Practice
NPI 1730669318
1901A MISSION 66
Vicksburg, MS 39180
(601) 636-0097
Same address
Qualified Speech Language Pathologist
NPI 1366034779
2080 S FRONTAGE RD STE 108
Vicksburg, MS 39180
(601) 883-1983
✔ Accepts Medicare1.2 mi
Physical Therapist in Private Practice
NPI 1659551802
1990 S FRONTAGE RD STE J
Vicksburg, MS 39180
(601) 883-1983
✔ Accepts Medicare1.2 mi
Occupational Therapist in Private Practice
NPI 1497120240
5473 YOUNGTON RD
Vicksburg, MS 39183
(601) 415-5761
15 mi
Occupational Therapist in Private Practice
NPI 1508104472
711 AVIGNON DR
Ridgeland, MS 39157
(601) 605-6777
✔ Accepts Medicare44 mi
Physical Therapist in Private Practice
NPI 1700300936
2314 PULASKI HWY STE A
North East, MD 21901
(410) 287-2940
✔ Accepts Medicare973 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Elite Performance And Rehab, LLC's NPI number?

The NPI number for Elite Performance And Rehab, LLC is 1255877346. It was assigned to this organization in the NPPES registry on January 12, 2017.

Where is Elite Performance And Rehab, LLC located?

Elite Performance And Rehab, LLC is located at 1901 A Mission 66, Vicksburg, MS 39180. The listed phone number is (601) 636-0097.

What is Elite Performance And Rehab, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Physical Therapy, with taxonomy code 261QP2000X.

Is Elite Performance And Rehab, LLC enrolled in Medicare?

Yes. Elite Performance And Rehab, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Elite Performance And Rehab, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 11 clinicians in 3 Medicare specialties reassign their Medicare billing to Elite Performance And Rehab, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Physical Therapist in Private Practice (7), Occupational Therapist in Private Practice (2) and Qualified Speech Language Pathologist (2). Of these, 6 practice at this address and 8 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Elite Performance And Rehab, LLC was last updated on July 18, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.