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MYOFASCIAL RELEASE OF SOUTHERN ILLINOIS
NPI 1851722946
Clinic/Center - Rehabilitation in Carbondale, IL

Active since November 27, 2013
101 S GRAHAM AVE, SUITE 3, CARBONDALE, IL 62901(618) 305-4696(888) 975-0097 Get Directions Write a Review

NPPES record last updated: November 4, 2014. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Myofascial Release Of Southern Illinois NPPES

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

MYOFASCIAL RELEASE OF SOUTHERN ILLINOIS (NPI 1851722946) is a healthcare organization registered as a rehabilitation in Carbondale, Illinois and active in the NPI registry since November 2013. The organization lists Tara Manzano, President/occupational Therapist, as its authorized official.

NPPES Registry Identity

NPI1851722946
Entity TypeOrganization
Primary Taxonomy261QR0400X
Legal Business NameMYOFASCIAL RELEASE OF SOUTHERN ILLINOIS
Location Address101 S GRAHAM AVE, SUITE 3Carbondale, IL 62901-3043
Mailing Address101 S Graham Ave, Suite 3Carbondale, IL 62901-3043 · (618) 305-4696 · Fax (888) 975-0097
Phone(618) 305-4696
Fax(888) 975-0097
Organization SubpartNo
Authorized OfficialTara ManzanoPresident/occupational Therapist · (618) 305-4696
Enumeration DateNovember 27, 2013
Last NPPES UpdateNovember 4, 2014
✔ NPI 1851722946 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · RehabilitationAmbulatory Health Care Facilities
Taxonomy Code261QR0400X
License✔ Licensed in IL · 248.000873
101 S GRAHAM AVE, Carbondale, IL 62901
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Myofascial Release Of Southern Illinois is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Myofascial Release Of Southern Illinois, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.

Clinicians, nearest first (2)

Tara Manzano, OTR/L
Occupational Therapist in Private Practice
NPI 1164853255
101 S GRAHAM AVE SUITE 3
Carbondale, IL 62901
(618) 305-4696
✔ Accepts MedicareSame address
Eric Manzano, P.T.
Physical Therapist in Private Practice
NPI 1356591895
306 W MILL ST
Carbondale, IL 62901
(618) 529-3060
✔ Accepts Medicare0.7 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 Myofascial Release Of Southern Illinois's NPI number?

The NPI number for Myofascial Release Of Southern Illinois is 1851722946. It was assigned to this organization in the NPPES registry on November 27, 2013.

Where is Myofascial Release Of Southern Illinois located?

Myofascial Release Of Southern Illinois is located at 101 S Graham Ave Suite 3, Carbondale, IL 62901. The listed phone number is (618) 305-4696.

What is Myofascial Release Of Southern Illinois's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rehabilitation, with taxonomy code 261QR0400X.

Is Myofascial Release Of Southern Illinois enrolled in Medicare?

Yes. Myofascial Release Of Southern Illinois is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Myofascial Release Of Southern Illinois?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Myofascial Release Of Southern Illinois, in Occupational Therapist in Private Practice and Physical Therapist in Private Practice. 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. Of these, 1 practice at this address and 2 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 Myofascial Release Of Southern Illinois was last updated on November 4, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.