Individual provider Active NPI

Daniel Courtenay, MPT

  • Physical Therapist
  • Gulfport, MS
National Provider Identifier
1124518444
Registry record updated Nov 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT3968 Issued in MS
Practice address
12261 Highway 49 Ste 1
Gulfport, MS 39503-2976
Phone
(228) 860-9676
Fax
(228) 860-9676
NPI assigned
May 11, 2018
Last updated
Nov 9, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2023

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 PT3968 MS Primary

Addresses

Primary practice location

12261 Highway 49 Ste 1
Gulfport, MS 39503-2976

Mailing address

12261 Highway 49 Ste 1
Gulfport, MS 39503-2976
Phone (228) 860-9676

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060213000709 MS Practitioner - Physical Therapist in Private Practice 1759396781 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Exceed of Ms, LLC Physical Therapist CurrentSince Sep 17, 2023 Accepting new patients
Exceed of Ms, LLC Physical Therapist Current Accepting new patients
Family Physical Therapy of South Ms CurrentSince Jan 1, 2025 Accepting new patients
Physiotherapy Associates Inc Past Accepting new patients
Ms Medical Supplies, Inc. Past Accepting new patients

Locations

12261 Highway 49
Ste 1
Gulfport, MS 39503
Phone (228) 265-7185

19020 Pineville Rd
Ste 4
Long Beach, MS 39560
Phone (228) 863-4080

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1525996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699488000000",
    "number": "1124518444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12261 HIGHWAY 49 STE 1",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395032976",
            "telephone_number": "228-860-9676",
            "fax_number": "228-860-9676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12261 HIGHWAY 49 STE 1",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395032976",
            "telephone_number": "228-860-9676",
            "fax_number": "228-860-9676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COURTENAY",
        "first_name": "DANIEL",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-11",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT3968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulfport, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.