SOUTHERN INDIANA MYOFASCIAL RELEASE, LLC
NPI 1801295043
Clinic/Center - Rehabilitation in Paoli, IN
About Southern Indiana Myofascial Release, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SOUTHERN INDIANA MYOFASCIAL RELEASE, LLC (NPI 1801295043) is a healthcare organization registered as a rehabilitation in Paoli, Indiana and active in the NPI registry since August 2014. The organization lists Brenda Jean Pardy, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Southern Indiana Myofascial Release, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Southern Indiana Myofascial Release, LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
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 Southern Indiana Myofascial Release, LLC's NPI number?
The NPI number for Southern Indiana Myofascial Release, LLC is 1801295043. It was assigned to this organization in the NPPES registry on August 13, 2014.
Where is Southern Indiana Myofascial Release, LLC located?
Southern Indiana Myofascial Release, LLC is located at 101 NW 1st St Ste D, Paoli, IN 47454. The listed phone number is (812) 788-1118.
What is Southern Indiana Myofascial Release, LLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Rehabilitation, with taxonomy code 261QR0400X.
Is Southern Indiana Myofascial Release, LLC enrolled in Medicare?
Yes. Southern Indiana Myofascial Release, LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Southern Indiana Myofascial Release, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Occupational Therapist in Private Practice) reassigns their Medicare billing to Southern Indiana Myofascial Release, 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Southern Indiana Myofascial Release, LLC was last updated on November 2, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.
# Southern Indiana Myofascial Release, Llc · NPI 1801295043
Rehabilitation organization in Paoli, Indiana. Organization record, active in the CMS NPPES registry since August 13, 2014.
## Identity
- **NPI:** 1801295043 (Entity type: Organization)
- **Enumerated:** August 13, 2014
- **Primary specialty:** Clinic/Center - Rehabilitation · taxonomy 261QR0400X
- **Organization subpart:** No
- **Authorized official:** Brenda Pardy, OWNER
## Practice location
- **Address:** 101 NW 1ST ST STE D, Paoli, IN 47454-1369
- **Phone:** (812) 788-1118
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Occupational Therapist in Private Practice) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** November 2, 2019
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Source: [NPI Profile](https://npiprofile.com/npi/1801295043) · Data from the CMS NPPES public registry.