Active NPI
Erica Goldsmith
- Physical Therapist
- Clinton, MS
National Provider Identifier
1164903902
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5812
- Practice address
- 719 Clinton Pkwy Ste B
Clinton, MS 39056-5245 - Phone
- (601) 924-7828
- Fax
- (601) 924-3979
- NPI assigned
- Aug 28, 2018
- Last updated
- Aug 28, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5812 | MS | Primary |
Addresses
Primary practice location
719 Clinton Pkwy Ste B
Clinton, MS 39056-5245
Mailing address
719 Clinton Pkwy Ste B
Clinton, MS 39056-5245
Phone (601) 924-7828
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5812 | Other | MS | PT LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5812 | MS | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1535414400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1535414400000",
"number": "1164903902",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "719 CLINTON PKWY STE B",
"city": "CLINTON",
"state": "MS",
"postal_code": "390565245",
"telephone_number": "601-924-7828",
"fax_number": "601-924-3979"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "719 CLINTON PKWY STE B",
"city": "CLINTON",
"state": "MS",
"postal_code": "390565245",
"telephone_number": "601-924-7828",
"fax_number": "601-924-3979"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDSMITH",
"first_name": "ERICA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-28",
"last_updated": "2018-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MS",
"license": "5812",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PT LICENSE",
"identifier": "5812",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Clinton, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.