Footprints Pediatric Therapy, PLLC

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

PT6066 Issued in MS

Legal business name

FOOTPRINTS PEDIATRIC THERAPY, PLLC

Practice address

135 Pinehills Dr
Hattiesburg, MS 39402-3317

Phone

(864) 293-3281

NPI assigned

Aug 25, 2016

Last updated

Sep 6, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Virginia C. Kolvites, DPTNPI 1730416678

Title

Owner

Phone

(864) 293-3281

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Virginia Claire Kolvites, DPT, PCS

  • Pediatric Physical Therapist
  • Hattiesburg, MS
  • NPI 1730416678

  Pediatrics

  NPD (past) Authorized official

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

{
    "created_epoch": "1472083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473120000000",
    "number": "1245786797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 PINEHILLS DR",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394023317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 PINEHILLS DR",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394023317",
            "telephone_number": "864-293-3281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOTPRINTS PEDIATRIC THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-25",
        "last_updated": "2016-09-06",
        "status": "A",
        "authorized_official_last_name": "KOLVITES",
        "authorized_official_first_name": "VIRGINIA",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "864-293-3281",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Pediatrics",
            "state": "MS",
            "license": "PT6066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arthur Nick Fokakis, M.D.
• Melanie Renee Foley, APRN, FNP-BC
• Julia Margaret Folse, LMSW
• Alexey Fomin, M.D., PH.D.
• Foot Clinic of Hattiesburg, P.a.
• Cassandra Ford
• Jasmine Ford
• Julie Ford, CFNP
• Rebecca A Ford, PCAC
• Victoria Ashley Ford, FNP

• Pediatric Physical Therapist in Hattiesburg, MS
• Providers in Hattiesburg, MS by specialty
• Pediatric Physical Therapist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2016; 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.