NPIMap

Organization Active NPI

Golden Triangle Physical Therapy Inc.

  • Physical Therapist
  • Louisville, MS
National Provider Identifier
1235154048
Registry record updated Jul 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
GOLDEN TRIANGLE PHYSICAL THERAPY INC.
Practice address
17045 E Main St
Louisville, MS 39339-2754
Phone
(662) 773-3700
Fax
(662) 773-3727
NPI assigned
Jul 13, 2006
Last updated
Jul 14, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2021

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

Authorized official

Name
Misty Dempsey
Title
Office Manager
Phone
(662) 773-3700

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT1026 MS
Physical Therapist 225100000X NU Primary
Family Nurse Practitioner 363LF0000X NU

Addresses

Primary practice location

17045 E Main St
Louisville, MS 39339-2754

Mailing address

17045 E Main St
Louisville, MS 39339-2754
Phone (662) 773-3700

Other identifiers 1

IdentifierTypeStateIssuer
9014488MedicaidMS

Other names 2

  • GTPT Other name
  • Red Hills Orthopedics Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111103000923 MS Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 0345419594 Practice locations: Louisville, MS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1235154048. Details of each certification follow.

  • CCN 256536 Outpatient physical therapy / speech pathology · Active · Name & address match · Details

Outpatient physical therapy / speech pathology certification: CCN 256536

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
GT PHYSICAL THERAPY - RED HILLS ORTHOPEDICS
Certification status
Active
Provider type (POS)
Outpatient physical therapy / speech pathology
Participating since
Jun 8, 1994
Last certification
Feb 27, 2020
Ownership / control type
Proprietary
Facility address
17045 East Main Street
Louisville, MS 39339

National Provider Directory

National Provider Directory

Locations

17045 E Main St
Louisville, MS 39339
Phone (662) 773-3700

1408 Ingalls Ave
Pascagoula, MS 39567
Phone (228) 696-1963

1201 Highway 49 S
Ste 30
Richland, MS 39218
Phone (601) 420-4061

2156 Old West Point Rd
Starkville, MS 39759
Phone (662) 323-2883

Practitioners & affiliated clinicians

Practitioners 11

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": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626220800000",
    "number": "1235154048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17045 E MAIN ST",
            "city": "LOUISVILLE",
            "state": "MS",
            "postal_code": "393392754",
            "telephone_number": "662-773-3700",
            "fax_number": "662-773-3727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17045 E MAIN ST",
            "city": "LOUISVILLE",
            "state": "MS",
            "postal_code": "393392754",
            "telephone_number": "662-773-3700",
            "fax_number": "662-773-3727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDEN TRIANGLE PHYSICAL THERAPY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2021-07-14",
        "certification_date": "2021-07-02",
        "status": "A",
        "authorized_official_last_name": "DEMPSEY",
        "authorized_official_first_name": "MISTY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "662-773-3700"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT1026",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9014488",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GTPT",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Red Hills Orthopedics",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Louisville, MS

Sources for this page

Verify at the official NPI Registry.