NPIMap

Organization Active NPI

Medicomp, Inc

Doing business as Medicomp Physical Therapy Jackson

  • Physical Therapist
  • Jackson, MS
National Provider Identifier
1144338070
Registry record updated Feb 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
MEDICOMP, INC
Doing business as
Medicomp Physical Therapy Jackson
Practice address
1054 Greymont Ave
Jackson, MS 39202-2718
Phone
(601) 355-9624
Fax
(601) 353-6151
NPI assigned
Aug 29, 2006
Last updated
Feb 4, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
MEDICOMP, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 4, 2014

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

Authorized official

Name
Joseph McNulty III
Title
Ceo
Phone
(601) 849-6440

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary
Physical Therapy Clinic/Center 261QP2000X MS

Addresses

Primary practice location

1054 Greymont Ave
Jackson, MS 39202-2718

Mailing address

110 Pioneer Way
Magee, MS 39111
Phone (601) 849-6440

Other names 1

  • Medicomp Physical Therapy Jackson Doing business as

National Provider Directory

National Provider Directory
Part of
Medicomp Inc

Practitioners & affiliated clinicians

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391472000000",
    "number": "1144338070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 PIONEER WAY",
            "city": "MAGEE",
            "state": "MS",
            "postal_code": "39111",
            "telephone_number": "601-849-6440",
            "fax_number": "601-353-6151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1054 GREYMONT AVE",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022718",
            "telephone_number": "601-355-9624",
            "fax_number": "601-353-6151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICOMP, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDICOMP, INC",
        "enumeration_date": "2006-08-29",
        "last_updated": "2014-02-04",
        "status": "A",
        "authorized_official_last_name": "MCNULTY",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "601-849-6440",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MS",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medicomp Physical Therapy Jackson",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2014; 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.