Individual provider Active NPI

Taylor Purnell, DPT

  • Physical Therapist
  • Hernando, MS
National Provider Identifier
1003679358
Registry record updated Jan 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT7691 Issued in MS
Practice address
2631 McIngvale Rd Ste 108
Hernando, MS 38632-5936
Phone
(662) 469-9054
NPI assigned
Jan 31, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT7691 MS Primary

Addresses

Primary practice location

2631 McIngvale Rd Ste 108
Hernando, MS 38632-5936

Mailing address

632 W Poplar Ave
Collierville, TN 38017-2540
Phone (901) 850-5246

Other practice location 1

632 W Poplar Ave
Collierville, TN 38017-2540
Phone (901) 850-5246

Other practice location 2

9087 Poplar Ave Ste 103
Germantown, TN 38138-7846
Phone (901) 627-3280

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, TN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240216001302 MS Practitioner - Physical Therapist in Private Practice 6507200698 Reassigns benefits to 1 organization
I20240301000464 TN Practitioner - Physical Therapist in Private Practice 6507200698 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT7691MSMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pittman Physical Therapy LLC Physical Therapist CurrentSince Feb 1, 2024 Accepting new patients
Napoli Physical Therapy LLC CurrentSince Feb 1, 2024 Accepting new patients

Locations

2631 McIngvale Rd
Ste 108
Hernando, MS 38632
Phone (662) 469-9054

622 W Poplar Ave
Ste 5
Collierville, TN 38017
Phone (901) 850-5246

632 W Poplar Ave
Collierville, TN 38017
Phone (901) 850-5246

9087 Poplar Ave
Ste 103
Germantown, TN 38138
Phone (901) 627-3280

Interoperability endpoints

  • Direct secure messaging: taylor.purnell.1@1366.direct.athenahealth.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1706659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1003679358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "632 W POPLAR AVE",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380172540",
            "telephone_number": "901-850-5246",
            "fax_number": "901-850-5226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2631 MCINGVALE RD STE 108",
            "city": "HERNANDO",
            "state": "MS",
            "postal_code": "386325936",
            "telephone_number": "662-469-9054"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "632 W Poplar Ave",
            "address_purpose": "LOCATION",
            "city": "Collierville",
            "state": "TN",
            "postal_code": "380172540",
            "country_code": "US",
            "telephone_number": "901-850-5246",
            "fax_number": "901-850-5226",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9087 Poplar Ave Ste 103",
            "address_purpose": "LOCATION",
            "city": "Germantown",
            "state": "TN",
            "postal_code": "381387846",
            "country_code": "US",
            "telephone_number": "901-627-3280",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PURNELL",
        "first_name": "TAYLOR",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-31",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT7691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hernando, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.