Active NPI
Jerrica Thomas
- Orthopedic Physical Therapist
- Southaven, MS
National Provider Identifier
1083023675
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- 5615
- Practice address
- 7545 Airways Blvd
Southaven, MS 38671-5806 - Phone
- (901) 759-3208
- NPI assigned
- Aug 7, 2014
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | 5615 | MS | Primary |
Addresses
Primary practice location
7545 Airways Blvd
Southaven, MS 38671-5806
Mailing address
1400 S Germantown Rd
Germantown, TN 38138-2205
Phone (901) 759-3180
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5615 | MS | MD | Orthopedic Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CC Bpci PLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Orthopaedic Surgery Physician
- Germantown, TN
- NPI 1881387330
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407369600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407369600000",
"number": "1083023675",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1400 S GERMANTOWN RD",
"city": "GERMANTOWN",
"state": "TN",
"postal_code": "381382205",
"telephone_number": "901-759-3180"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7545 AIRWAYS BLVD",
"city": "SOUTHAVEN",
"state": "MS",
"postal_code": "386715806",
"telephone_number": "901-759-3208"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMAS",
"first_name": "JERRICA",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-08-07",
"last_updated": "2014-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "MS",
"license": "5615",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Southaven, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.