Individual provider Active NPI

Charles Webster Jr

  • Physical Therapist
  • Memphis, TN
National Provider Identifier
1043833825
Registry record updated Jun 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
13046 Issued in TN
Practice address
950 Cherry Rd
Memphis, TN 38117-5431
Phone
(901) 930-0817
NPI assigned
May 27, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2022

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 13046 TN Primary

Addresses

Primary practice location

950 Cherry Rd
Memphis, TN 38117-5431

Mailing address

599C Steed Rd
Ridgeland, MS 39157-1707
Phone (601) 605-6777

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230817000122 MS Practitioner - Physical Therapist in Private Practice 7517329907 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13046TNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Creative Health Care Management LLC Physical Therapist CurrentSince May 1, 2023 Accepting new patients
Creative Health Care Management LLC Physical Therapist CurrentSince May 1, 2023 Accepting new patients

Locations

10 S 9th St
Ste 4
Noblesville, IN 46060

6600 Poplar Springs Dr
Meridian, MS 39305
Phone (601) 482-5561

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": "1590537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655942400000",
    "number": "1043833825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "599C STEED RD",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391571707",
            "telephone_number": "601-605-6777",
            "fax_number": "601-813-5460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 CHERRY RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381175431",
            "telephone_number": "901-930-0817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBSTER JR",
        "first_name": "CHARLES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-27",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "13046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2022; 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.