Individual provider Active NPI

Millie Grace Mask, PT

  • Physical Therapist
  • Brandon, MS
National Provider Identifier
1104743145
Registry record updated Jul 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT8157 Issued in MS
Practice address
2015 Highpointe Dr
Brandon, MS 39042-3169
Phone
(601) 724-8886
Fax
(601) 724-8887
NPI assigned
Jul 1, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2026

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 PT8157 MS Primary

Addresses

Primary practice location

2015 Highpointe Dr
Brandon, MS 39042-3169

Mailing address

25025 Highway 15
Union, MS 39365-8577
Phone (769) 222-1053

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

NPI Registry JSON

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

{
    "created_epoch": "1782864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782864000000",
    "number": "1104743145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25025 HIGHWAY 15",
            "city": "UNION",
            "state": "MS",
            "postal_code": "393658577",
            "telephone_number": "769-222-1053",
            "fax_number": "769-222-1167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 HIGHPOINTE DR",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390423169",
            "telephone_number": "601-724-8886",
            "fax_number": "601-724-8887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASK",
        "first_name": "MILLIE",
        "middle_name": "GRACE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-07-01",
        "last_updated": "2026-07-01",
        "certification_date": "2026-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT8157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2026; 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.