Michael Scott Childers, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT7772 Issued in MS

Practice address

1211 S Gloster St Ste C
Tupelo, MS 38801-6548

Phone

(662) 432-1523

Fax

(662) 432-1528

NPI assigned

Jun 5, 2024

Last updated

Jun 5, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

University of Mississippi School of Medicine, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sog Physical TherapyGroup PAC ID 1850627209, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Sog Physical Therapy

  • Multi-Specialty Clinic/Center
  • Tupelo, MS
  • NPI 1902361660

  Physical Therapist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1717545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1144061706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 S GLOSTER ST STE C",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388016548",
            "telephone_number": "662-432-1523",
            "fax_number": "662-432-1528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 S GLOSTER ST STE C",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388016548",
            "telephone_number": "662-432-1523",
            "fax_number": "662-432-1528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHILDERS",
        "first_name": "MICHAEL",
        "middle_name": "SCOTT",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-05",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT7772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Chase, FNP-C
• Kiran Chatha, DO, MPH
• Melissa M Chatham, MS CCC-SP
• Gail Frances Cherry
• Cheyenne Total Care LLC
• Children's Clinic of Tupelo, PA
• Children's Dental Clinic, PA (Children's Dental Clinic)
• Jessica Braddock Childs, AGNP
• David J Chisholm, CRNA
• Suzanne Chittom, M.S., OTR/L

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.