Active NPI
Jason Guynes King, PTA
- Physical Therapy Assistant
- Grenada, MS
National Provider Identifier
1083005086
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 5569
- Practice address
- 968 Highland Hills Rd
Grenada, MS 38901-9031 - Phone
- (662) 226-3433
- NPI assigned
- Feb 11, 2015
- Last updated
- Feb 11, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 5569 | MS | Primary |
Addresses
Primary practice location
968 Highland Hills Rd
Grenada, MS 38901-9031
Mailing address
968 Highland Hills Rd
Grenada, MS 38901-9031
Phone (662) 226-3433
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5569 | MS | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1423612800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1423612800000",
"number": "1083005086",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "968 HIGHLAND HILLS RD",
"city": "GRENADA",
"state": "MS",
"postal_code": "389019031",
"telephone_number": "662-226-3433"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "968 HIGHLAND HILLS RD",
"city": "GRENADA",
"state": "MS",
"postal_code": "389019031",
"telephone_number": "662-226-3433"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KING",
"first_name": "JASON",
"middle_name": "GUYNES",
"credential": "PTA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-02-11",
"last_updated": "2015-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "MS",
"license": "5569",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grenada, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.