NPIMap

Organization Active NPI

Capital Orthopaedic Clinic PLLC

  • Orthopedic Physical Therapist
  • Flowood, MS
National Provider Identifier
1184299273
Registry record updated Jun 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
Legal business name
CAPITAL ORTHOPAEDIC CLINIC PLLC
Practice address
104 Burney Dr
Flowood, MS 39232-6621
Phone
(601) 987-8200
Fax
(601) 987-8211
NPI assigned
May 21, 2021
Last updated
Jun 14, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
CAPITAL ORTHOPAEDIC CLINIC, PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 14, 2021

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

Authorized official

Name
Katie Russell
Title
Business Office Manager
Phone
(601) 987-8200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X NU Primary

Addresses

Primary practice location

104 Burney Dr
Flowood, MS 39232-6621

Mailing address

PO Box 30594
Charlotte, NC 28230-0594
Phone (601) 987-8200

Other practice location 1

119 Highway 80 E
Clinton, MS 39056-4738
Phone (601) 708-1834

Other names 1

  • Capital Orthopaedic Clinic PT Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060208000127 MS Part B Supplier - Clinic/Group Practice 0941215255 Receives reassigned benefits from 56 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Madison, MS; Jackson, MS; Flowood, MS; Clinton, MS; Brandon, MS; Brookhaven, MS

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Part of
Capital Orthopaedic Clinic

Locations

1035 Star Rd
Ste Ab
Brandon, MS 39042
Phone (769) 348-4505

601 Brookman Dr Ext
Brookhaven, MS 39601
Phone (601) 823-5275

119 Highway 80 E
Clinton, MS 39056
Phone (601) 708-1834

290 E Layfair Dr
#A
Flowood, MS 39232
Phone (601) 981-2825

1701 N State St
Rm 133
Jackson, MS 39210
Phone (769) 216-1004

953 Highway 51
Madison, MS 39110
Phone (769) 867-8270

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 66

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 66

NPI Registry JSON

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

{
    "created_epoch": "1621555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623628800000",
    "number": "1184299273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30594",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282300594",
            "telephone_number": "601-987-8200",
            "fax_number": "601-987-8211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 BURNEY DR",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392326621",
            "telephone_number": "601-987-8200",
            "fax_number": "601-987-8211"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "119 Highway 80 E",
            "address_purpose": "LOCATION",
            "city": "Clinton",
            "state": "MS",
            "postal_code": "390564738",
            "country_code": "US",
            "telephone_number": "601-708-1834",
            "fax_number": "601-708-1837",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CAPITAL ORTHOPAEDIC CLINIC PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CAPITAL ORTHOPAEDIC CLINIC, PLLC",
        "enumeration_date": "2021-05-21",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "KATIE",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "601-987-8200"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Capital Orthopaedic Clinic PT",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Capital Orthopaedic Clinic PT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Flowood, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2021; 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.