Individual provider Active NPI

Charles David Herrington

  • Physical Therapist
  • Jackson, MS
National Provider Identifier
1043263122
Registry record updated Feb 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT0263 Issued in MS
Practice address
1200 N State St
Suite 500
Jackson, MS 39202-2000
Phone
(601) 352-2273
Fax
(601) 714-3415
NPI assigned
May 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2018

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 PT0263 MS Primary

Addresses

Primary practice location

1200 N State St
Suite 500
Jackson, MS 39202-2000

Mailing address

965 Ridge Lake Blvd Ste 103
Memphis, TN 38120-9446
Phone (901) 227-3255

Other identifiers 1

IdentifierTypeStateIssuer
05985328MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040817000639 MS Practitioner - Physical Therapist in Private Practice 4486635208 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1200 N State St
Suite 500
Jackson, MS 39202-2027
Phone (601) 352-2273

Merit-based Incentive Payment System (MIPS)

Final score
78.38 of 100Reported as group
Quality
54.22
Promoting interoperability
100
Improvement activities
40
Cost
73.72

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT0263MSMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Foundation of Central Ms CurrentSince Oct 1, 2015 Accepting new patients
Medical Foundation of Central Mississippi, Inc. Physical Therapist Current Accepting new patients
Medical Foundation of Central Mississippi, Inc CurrentSince Oct 1, 2015 Accepting new patients
University Orthopedic Associates, PLLC Past Accepting new patients

Locations

108 Clinton Pkwy
Clinton, MS 39056
Phone (601) 926-2018

151 E Metro Dr
Ste 202
Flowood, MS 39232
Phone (601) 973-1507

4301 Lakeland Dr
Flowood, MS 39232
Phone (601) 939-7010

102 Lexington Dr
#100
Gluckstadt, MS 39110
Phone (601) 973-1688

1200 N State St
Ste 210
Jackson, MS 39202
Phone (601) 714-3202

1225 N State St
Jackson, MS 39202
Phone (601) 292-4261

1200 N State St
Ste 500
Jackson, MS 39202
Phone (601) 352-2273

1200 N State St
Ste 480
Jackson, MS 39202
Phone (601) 352-2273

6250 Old Canton Rd
Ste 130
Jackson, MS 39211
Phone (601) 956-7280

401 Baptist Dr
Ste 104
Madison, MS 39110
Phone (601) 605-2383

401 Baptist Dr
Ste 306
Madison, MS 39110
Phone (601) 607-7204

746 E Fifteenth St
Yazoo City, MS 39194
Phone (662) 746-4032

965 Ridge Lake Blvd
Ste 103
Memphis, TN 38120
Phone (901) 227-3221

Organizations & group practices 4

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": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518393600000",
    "number": "1043263122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 RIDGE LAKE BLVD STE 103",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381209446",
            "telephone_number": "901-227-3255",
            "fax_number": "901-227-8591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N STATE ST",
            "address_2": "SUITE 500",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022000",
            "telephone_number": "601-352-2273",
            "fax_number": "601-714-3415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRINGTON",
        "first_name": "CHARLES",
        "middle_name": "DAVID",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2018-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT0263",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05985328",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.