Individual provider Active NPI

Justin Allen Vanlandingham

  • Physical Therapist
  • Lonoke, AR
National Provider Identifier
1194069351
Registry record updated Nov 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT3552 Issued in AR
Practice address
1515 N Center St
Suite 5
Lonoke, AR 72086-2101
Phone
(501) 676-5540
Fax
(501) 676-6499
NPI assigned
Nov 12, 2012
Last updated
Nov 12, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT3552 AR Primary

Addresses

Primary practice location

1515 N Center St
Suite 5
Lonoke, AR 72086-2101

Mailing address

1515 N Center St
Suite 5
Lonoke, AR 72086-2101
Phone (501) 676-5540

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221025000181 MS Practitioner - Physical Therapist in Private Practice 5799937454 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Campbell Clinic, PCGroup PAC ID 9638082076, 229 clinicians

Practice addresses (Care Compare)

7545 Airways Blvd
Southaven, MS 38671-5806
Phone (901) 759-3196

Merit-based Incentive Payment System (MIPS)

Final score
75.09 of 100Reported as group
Quality
50.47
Promoting interoperability
99
Improvement activities
40
Cost
67.33

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Campbell Clinic, PC CurrentSince Sep 29, 2022 Accepting new patients
Campbell Clinic PC CurrentSince Sep 29, 2022 Accepting new patients
Arkansas Health & Rehab LLC Physical Therapist CurrentSince Jun 15, 2021 Accepting new patients
Lonoke Physical Therapy, Inc Physical Therapist CurrentSince Nov 12, 2012 Accepting new patients
CC Bpci PLC Past Accepting new patients

Locations

1515 N Center St
Ste 5
Lonoke, AR 72086
Phone (501) 676-5540

7545 Airways Blvd
Southaven, MS 38671
Phone (901) 759-3196

1400 S Germantown Rd
Memphis, TN 38138
Phone (901) 759-3111

Interoperability endpoints

  • Direct secure messaging: justin.vanlandingham.1@1366.direct.athenahealth.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1352678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352678400000",
    "number": "1194069351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 N CENTER ST",
            "address_2": "SUITE 5",
            "city": "LONOKE",
            "state": "AR",
            "postal_code": "720862101",
            "telephone_number": "501-676-5540",
            "fax_number": "501-676-6499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 N CENTER ST",
            "address_2": "SUITE 5",
            "city": "LONOKE",
            "state": "AR",
            "postal_code": "720862101",
            "telephone_number": "501-676-5540",
            "fax_number": "501-676-6499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANLANDINGHAM",
        "first_name": "JUSTIN",
        "middle_name": "ALLEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-11-12",
        "last_updated": "2012-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "PT3552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lonoke, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2012; 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.