Exceed Physical Therapy, LLC
Organization Active NPI Physical Therapist · Gulfport, MS
NPI 1023508348 · NPPES record last updated May 11, 2018
Key facts
- NPI
- 1023508348
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapist 225100000X
- Legal business name
- EXCEED PHYSICAL THERAPY, LLC
- Practice address
- 12261 Highway 49 Ste 1
Gulfport, MS 39503-2976 - Phone
- (228) 861-4218
- NPI assigned
- May 11, 2018
- Organization subpart
- No
Authorized official
- Name
- Chad Blalack
- Title
- Manager
- Phone
- (228) 860-9676
Practitioners 79
-
Ryan H. Harrell, DPT
-
John H Kirk III, PT
-
Samantha C Pierce, OTR/L
-
Lindsey F Byrd, PT
-
Deanna Garrard, PT
-
Taylor Tubertini Mattina, PT, DPT
-
Todd Michael Smith, RPT
-
Nicholas Wyrosdick, DPT
-
Daniel Courtenay, MPT
-
Lissa Kelly Baber, AGACNP
-
Boyd P. Benefield, M.D.
-
Pamela Bingham, P.A.
-
Nathan D Boles, MD
-
Molly Bailey Brown, FNP
-
Brian Wayne Caswell, CFNP
-
Leslie Sue Chambers, APRN
-
Phillip D Compton II, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in MS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180910002531 | MS | Part B Supplier - Physical/Occupational Therapy Group in Private Practice | 8123378338 |
Receives reassigned benefits from 15 practitioners Practice locations: Gulfport, MS |
| O20191211003103 | MS | Part a Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services | 8123378338 | Practice locations: Gulfport, MS |
| O20250905000723 | MS | DME Supplier - Independently-Practicing Occupational Therapist | 8123378338 | Practice locations: Gulfport, MS |
National Provider Directory
Locations
12261 Highway 49
Ste 1
Gulfport, MS 39503
Phone (228) 265-7185
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | Yes |
Addresses
Primary practice location
12261 Highway 49 Ste 1
Gulfport, MS 39503-2976
Mailing address
3 Bayou PL
Gulfport, MS 39503-6202
Phone (228) 861-4218
Other providers in Gulfport, MS
- La'Shantee Evans
- Traci Evans
- Brittany Stewart Everhart
- Carlos Evers
- Exceed Pelvic Health LLC
- Express Transit
- Eyemart Express LLC
- Eyemart Express LTD
- Caira D Fairley
- Crystal Tamika Fairley
All providers in Gulfport, MS · Physical Therapist in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 11, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.