NPIMap

Organization Active NPI

2083 Therapy, LLC

Doing business as 2083 Therapy of Hazelhurst

  • Physical Therapy Clinic/Center
  • Hazlehurst, MS
National Provider Identifier
1174042360
Registry record updated Apr 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
2083 THERAPY, LLC
Doing business as
2083 Therapy of Hazelhurst
Apex Physical Therapy of Copiah
Practice address
236 Caldwell Dr
Hazlehurst, MS 39083-2723
Phone
(601) 894-9004
NPI assigned
Sep 19, 2017
Last updated
Apr 24, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2020

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

Authorized official

Name
Joseph S McNulty IV
Title
President
Phone
(601) 849-6440

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X NU Primary

Addresses

Primary practice location

236 Caldwell Dr
Hazlehurst, MS 39083-2723

Mailing address

100 Pioneer Way
Magee, MS 39111-5501
Phone (601) 849-6440

Other identifiers 1

IdentifierTypeStateIssuer
1109164OtherMSBUSINESS LICENSE

Other names 2

  • 2083 Therapy of Hazelhurst Doing business as
  • Apex Physical Therapy of Copiah Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180328000512 MS Part B Supplier - Physical/Occupational Therapy Group in Private Practice 4082976246 Receives reassigned benefits from 15 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Collins, MS; Flowood, MS; Forest, MS; Hazlehurst, MS; Magee, MS; Philadelphia, MS

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
2083 Therapy LLC12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Locations

110 Pioneer Way
Magee, MS 39111

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1505779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587686400000",
    "number": "1174042360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PIONEER WAY",
            "city": "MAGEE",
            "state": "MS",
            "postal_code": "391115501",
            "telephone_number": "601-849-6440",
            "fax_number": "601-849-1332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "236 CALDWELL DR",
            "city": "HAZLEHURST",
            "state": "MS",
            "postal_code": "390832723",
            "telephone_number": "601-894-9004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "2083 THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-19",
        "last_updated": "2020-04-24",
        "certification_date": "2020-04-24",
        "status": "A",
        "authorized_official_last_name": "MCNULTY",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "601-849-6440",
        "authorized_official_name_suffix": "IV"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUSINESS LICENSE",
            "identifier": "1109164",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "2083 Therapy of Hazelhurst",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "2083 Therapy of Hazelhurst",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Apex Physical Therapy of Copiah",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hazlehurst, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2020; 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.