Active NPI
Antonio McCall
- Physical Therapy Assistant
- Southaven, MS
National Provider Identifier
1093355752
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 5057
- Practice address
- 2575 Russum Dr
Southaven, MS 38672-6564 - Phone
- (901) 649-2021
- NPI assigned
- Jan 10, 2020
- 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 | 5057 | TN | Primary |
Addresses
Primary practice location
2575 Russum Dr
Southaven, MS 38672-6564
Mailing address
2575 Russum Dr
Southaven, MS 38672-6564
Phone (901) 649-2021
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | mcantonio81@hotmail.com |
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 |
|---|---|---|---|
| 5057 | TN | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1578614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1578614400000",
"number": "1093355752",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2575 RUSSUM DR",
"city": "SOUTHAVEN",
"state": "MS",
"postal_code": "386726564",
"telephone_number": "901-649-2021"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2575 RUSSUM DR",
"city": "SOUTHAVEN",
"state": "MS",
"postal_code": "386726564",
"telephone_number": "901-649-2021"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCALL",
"first_name": "ANTONIO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-01-10",
"last_updated": "2020-01-10",
"certification_date": "2020-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "TN",
"license": "5057",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "mcantonio81@hotmail.com",
"affiliation": "N",
"address_1": "2575 Russum Dr",
"city": "Southaven",
"state": "MS",
"country_code": "US",
"postal_code": "386726564",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Jan 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.