Madison Grace Pena, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA7197 Issued in MS

Practice address

7580 Clarington CV
Southaven, MS 38671-5657

Phone

(901) 259-1600

Fax

(901) 259-1698

NPI assigned

Aug 12, 2021

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Cornerstone Rehabilitation of Batesville Inc

  • Physical Therapist
  • Batesville, MS
  • NPI 1639114390
  NPD (past)
• Cornerstone Rehabilitation of Senatobia Inc

  • Physical Therapist
  • Senatobia, MS
  • NPI 1043246192
  NPD (past)
• Cornerstone Rehabilitation of Southaven

  • Physical Therapist
  • Southaven, MS
  • NPI 1649719485
  NPD (past)

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

{
    "created_epoch": "1628726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699920000000",
    "number": "1255006037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6077 PRIMACY PKWY STE 140",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381195754",
            "telephone_number": "901-259-1973",
            "fax_number": "901-259-7637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7580 CLARINGTON CV",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386715657",
            "telephone_number": "901-259-1600",
            "fax_number": "901-259-1698"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "484 Church Rd E",
            "address_purpose": "LOCATION",
            "city": "Southaven",
            "state": "MS",
            "postal_code": "386719714",
            "country_code": "US",
            "telephone_number": "662-349-2489",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "421 E Commerce St",
            "address_purpose": "LOCATION",
            "city": "Hernando",
            "state": "MS",
            "postal_code": "386322348",
            "country_code": "US",
            "telephone_number": "662-449-4427",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "287 Highway 6 W",
            "address_purpose": "LOCATION",
            "city": "Batesville",
            "state": "MS",
            "postal_code": "386062557",
            "country_code": "US",
            "telephone_number": "662-578-7799",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1201 Office Park Dr",
            "address_purpose": "LOCATION",
            "city": "Oxford",
            "state": "MS",
            "postal_code": "386553598",
            "country_code": "US",
            "telephone_number": "662-371-1987",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENA",
        "first_name": "MADISON",
        "middle_name": "GRACE",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-12",
        "last_updated": "2023-11-14",
        "certification_date": "2023-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MS",
            "license": "PTA7197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Terri Peace, OTR/L
• Emily Pearson
• Leslie B Pearson, NP
• Turner Donaldson Peckham
• Airreal Pegues, MS
• Jennifer Petell, PH.D IN CLINICAL PSY
• Calleen Patricia Petersen, LMSW
• John S Petrides
• Tracey F Petrides, M.D.
• Blanche Foshee' Petty, APRN

• Physical Therapy Assistant in Southaven, MS
• Providers in Southaven, MS by specialty
• Physical Therapy Assistant in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2023; 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.