NPIMap

Organization Active NPI

Magnolia Therapy Services

  • Physical Therapist
  • Tupelo, MS
National Provider Identifier
1245005222
Registry record updated Jun 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
MAGNOLIA THERAPY SERVICES
Practice address
1890 McCullough Blvd Ste 103
Tupelo, MS 38801-6774
Phone
(662) 322-0980
NPI assigned
Nov 20, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2024

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

Authorized official

Name
Andrea Jones, PT, DPTNPI 1215386255
Title
PT/Owner
Phone
(662) 322-0980

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X

Addresses

Primary practice location

1890 McCullough Blvd Ste 103
Tupelo, MS 38801-6774

Mailing address

2622 Edgemont Cir
Tupelo, MS 38804-1074
Phone (662) 322-0980

Other names 1

  • MAGNOLIA KIDS THERAPY Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1700438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718755200000",
    "number": "1245005222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2622 EDGEMONT CIR",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388041074",
            "telephone_number": "662-322-0980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1890 MCCULLOUGH BLVD STE 103",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388016774",
            "telephone_number": "662-322-0980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA THERAPY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-20",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "PT/OWNER",
        "authorized_official_telephone_number": "662-322-0980",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MAGNOLIA KIDS THERAPY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MAGNOLIA KIDS THERAPY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tupelo, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.