Individual provider Active NPI

Ashley Keller Harbour

  • Physical Therapist
  • Hernando, MS
National Provider Identifier
1144902800
Registry record updated Feb 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT7869 Issued in MS
Practice address
2018 McIngvale Rd Ste 102
Hernando, MS 38632-8706
Phone
(662) 298-2276
Fax
(662) 298-2278
NPI assigned
Aug 2, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT-5320 AR
Physical Therapist 225100000X PT7869 MS Primary

Addresses

Primary practice location

2018 McIngvale Rd Ste 102
Hernando, MS 38632-8706

Mailing address

2018 McIngvale Rd Ste 102
Hernando, MS 38632-8706
Phone (662) 298-2276

Other practice location 1

105B Quality Ln
Senatobia, MS 38668-2317
Phone (662) 562-9977

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240913000240 MS Practitioner - Physical Therapist in Private Practice 3870033160 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athletico LTDGroup PAC ID 4789602681, 2,187 clinicians

Practice addresses (Care Compare)

2018 McIngvale Rd
Suite 102
Hernando, MS 38632-8706
Phone (662) 298-2276

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT-5320ARMDPhysical Therapist
PT7869MSMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Athletico LTD Physical Therapist CurrentSince Aug 19, 2024 Accepting new patients
Athletico LTD Physical Therapist CurrentSince Aug 19, 2024 Accepting new patients

Locations

2122 York Rd
Ste 300
Oak Brook, IL 60523
Phone (630) 575-6250

2018 McIngvale Rd
Ste 102
Hernando, MS 38632
Phone (662) 298-2276

105B Quality Ln
Senatobia, MS 38668
Phone (662) 562-9977

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1690934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738800000000",
    "number": "1144902800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2018 MCINGVALE RD STE 102",
            "city": "HERNANDO",
            "state": "MS",
            "postal_code": "386328706",
            "telephone_number": "662-298-2276",
            "fax_number": "662-298-2278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2018 MCINGVALE RD STE 102",
            "city": "HERNANDO",
            "state": "MS",
            "postal_code": "386328706",
            "telephone_number": "662-298-2276",
            "fax_number": "662-298-2278"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "105B Quality Ln",
            "address_purpose": "LOCATION",
            "city": "Senatobia",
            "state": "MS",
            "postal_code": "386682317",
            "country_code": "US",
            "telephone_number": "662-562-9977",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARBOUR",
        "first_name": "ASHLEY",
        "middle_name": "KELLER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-02",
        "last_updated": "2025-02-06",
        "certification_date": "2025-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "PT-5320",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT7869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hernando, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2025; 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.