NPIMap

Organization Active NPI

Medicomp, Inc.

Doing business as Medicomp Physical Therapy Blakely

  • Physical Therapy Clinic/Center
  • Blakely, GA
National Provider Identifier
1033574579
Registry record updated Feb 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
MEDICOMP, INC.
Doing business as
Medicomp Physical Therapy Blakely
Practice address
647 Flowers Drive
Blakely, GA 39823-2574
Phone
(229) 724-4269
Fax
(229) 723-2354
NPI assigned
Dec 29, 2015
Last updated
Feb 16, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2016

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

Authorized official

Name
Mr. Joseph McNulty
Title
Ceo
Phone
(601) 849-6440

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

647 Flowers Drive
Blakely, GA 39823-2574

Mailing address

2015 Highpointe Dr
Brandon, MS 39042-3169
Phone (601) 824-8914

Other names 1

  • Medicomp Physical Therapy Blakely Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Mediscan10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1451347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455580800000",
    "number": "1033574579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2015 HIGHPOINTE DR",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390423169",
            "telephone_number": "601-824-8914",
            "fax_number": "601-824-8828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "647 FLOWERS DRIVE",
            "city": "BLAKELY",
            "state": "GA",
            "postal_code": "398232574",
            "telephone_number": "229-724-4269",
            "fax_number": "229-723-2354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICOMP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-29",
        "last_updated": "2016-02-16",
        "status": "A",
        "authorized_official_last_name": "MCNULTY",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "601-849-6440",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medicomp Physical Therapy Blakely",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Blakely, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.