Clay Eckerson

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2014 Issued in MS

Practice address

133 Pine St
Hazlehurst, MS 39083-2309

Phone

(601) 894-2027

NPI assigned

Jan 14, 2011

Last updated

Jan 14, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Tri-Vista Rehab, Inc.Group PAC ID 0345390308, 26 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Tri-Vista Rehab, Inc

  • Physical Therapist
  • Tupelo, MS
  • NPI 1982799516
  Medicare reassignment Care Compare group NPD
• Tri-Vista Rehab, Inc

  dba TriVista Rehab at Community Development Inc.

  • Rehabilitation Clinic/Center
  • Richton, MS
  • NPI 1265025522
  NPD

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

{
    "created_epoch": "1294963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294963200000",
    "number": "1194020651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4109 HIGHWAY 98 W",
            "city": "SUMMIT",
            "state": "MS",
            "postal_code": "396669132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 PINE ST",
            "city": "HAZLEHURST",
            "state": "MS",
            "postal_code": "390832309",
            "telephone_number": "601-894-2027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ECKERSON",
        "first_name": "CLAY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-01-14",
        "last_updated": "2011-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "2014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Copiah County Medical Center
• Copiah Family Dentistry (Carl Anthony Boykin, DMD)
• Jazmin Corley, M.A
• Troy Donald Douglas, R.PH.
• Jason Downard
• George E Ellis, D.M.D.
• Family Wellness & Chiropractic
• Fast Pace Mississippi, PLLC
• Freds Stores of Tennessee Inc (Freds Pharmacy 1836)
• G & T Pharmaceutical Inc

• Physical Therapist in Hazlehurst, MS
• Providers in Hazlehurst, MS by specialty
• Physical Therapist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2011; 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.