Jerrie Ann Cummings, P.T.
Individual provider Active NPI Physical Therapist · De Witt, AR
NPI 1104819358 · NPPES record last updated Jun 25, 2008
Key facts
- NPI
- 1104819358
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT1005 (AR)
- Practice address
- 317 W 7TH St
De Witt, AR 72042-3279 - Phone
- (870) 946-8400
- Fax
- (870) 946-8511
- NPI assigned
- Aug 23, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Grand Prairie Physical Therapy of Stuttgart, Inc.
Practice addresses (Care Compare)
2024 S Buerkle St
Stuttgart, AR 72160-6508
Phone (870) 673-7679
317 W 7TH St
De Witt, AR 72042-3279
Phone (870) 946-8400
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080626000099 | AR | Practitioner - Physical Therapist in Private Practice | 7719058940 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT1005 | AR | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grand Prairie Physical Therapy, Inc. | Current |
Accepting new patients | |
| Grand Prairie Physical Therapy of Stuttgart, Inc. | Physical Therapist | Current |
Accepting new patients |
Locations
317 W 7th St
Dewitt, AR 72042
Phone (870) 946-8400
2024 S Buerkle St
Stuttgart, AR 72160
Phone (870) 377-7875
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT1005 | AR | Yes |
Addresses
Primary practice location
317 W 7TH St
De Witt, AR 72042-3279
Mailing address
317 W 7TH St
De Witt, AR 72042-3279
Phone (870) 946-8400
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 150837742 | Medicaid | AR | |
| 123614721 | Medicaid | AR | |
| 71084878830 | Other | AR | QUALCHOICE |
| 139762742 | Medicaid | AR |
Other providers in De Witt, AR
- Counce Therapy LLC
- Reid Allen Counce
- Rylee Counce
- Crestpark Dewitt, LLC
- Vernon Dewayne Crowell Jr.
- Dana'S House, Inc.
- James Mackenzie Daugherty
- Dean'S Pharmacy Clinic
- Deans Pharmacies, Inc.
- Dewitt Hospital & Nursing Home Inc.
All providers in De Witt, AR · Physical Therapist in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 25, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.