Stacy Whited Mansell, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT3654 Issued in MS

Practice address

950 E County Line Rd Ste a
Ridgeland, MS 39157-1928

Phone

(601) 308-5117

Fax

(601) 308-5103

NPI assigned

Aug 31, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Stacy Renee Whited Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Performance Rehab, Inc

  • Physical Therapy Clinic/Center
  • Ridgeland, MS
  • NPI 1568455889
  NPD (past)

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

{
    "created_epoch": "1535673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535673600000",
    "number": "1083196471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 E COUNTY LINE RD STE A",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391571928",
            "telephone_number": "601-308-5117",
            "fax_number": "601-308-5103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 E COUNTY LINE RD STE A",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391571928",
            "telephone_number": "601-308-5117",
            "fax_number": "601-308-5103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANSELL",
        "first_name": "STACY",
        "middle_name": "WHITED",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-31",
        "last_updated": "2018-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT3654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACY",
            "last_name": "WHITED",
            "middle_name": "RENEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Meagen M Mallett, OT
• Heather J Maloney, PT
• Tarah Aurelia Mannery, OTR/L, MS
• Joanna Manning, SLP
• Phylicia Manogin, OT
• Isabella Manuel
• Marathon Health LLC
• Jillian Mars, PT
• Carey L Marsalis, OT
• Ashley M Marshall, OT

• Physical Therapist in Ridgeland, MS
• Providers in Ridgeland, MS by specialty
• Physical Therapist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2018; 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.