Grand Prairie Physical Therapy, Inc.

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

PT1005 Issued in AR

Legal business name

GRAND PRAIRIE PHYSICAL THERAPY, INC.

Practice address

317 W 7TH St
De Witt, AR 72042-3279

Phone

(870) 946-8400

Fax

(870) 946-8511

NPI assigned

Jun 15, 2006

Last updated

Jun 25, 2008By 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

Mrs. Jerrie Ann Cummings, P.T.NPI 1104819358

Title

Co-Owner

Phone

(870) 946-8400

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Locations

Practitioners 2

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.

• Jerrie Ann Cummings, P.T.

  • Physical Therapist
  • De Witt, AR
  • NPI 1104819358
  Medicare reassignment NPD Authorized official
• Allyson Coker, PT

  • Physical Therapist
  • Stuttgart, AR
  • NPI 1164273371
  Medicare reassignment NPD

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214352000000",
    "number": "1285678052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 W 7TH ST",
            "city": "DE WITT",
            "state": "AR",
            "postal_code": "720423279",
            "telephone_number": "870-946-8400",
            "fax_number": "870-946-8511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 W 7TH ST",
            "city": "DE WITT",
            "state": "AR",
            "postal_code": "720423279",
            "telephone_number": "870-946-8400",
            "fax_number": "870-946-8511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND PRAIRIE PHYSICAL THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-15",
        "last_updated": "2008-06-25",
        "status": "A",
        "authorized_official_last_name": "CUMMINGS",
        "authorized_official_first_name": "JERRIE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "870-946-8400",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "AR",
            "license": "PT1005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139762742",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Easy Living
• Economy Drug of Dewitt
• Brandyn Tyler England, PHARMD
• Evergreene Properties of North Carolina,LLC (Crestpark Inn of Dewitt)
• Julie Beth Gardner, MD
• Laura Ann Hannum, APRN
• Michael Harris
• John Richard Holt Hestir, DDS
• Randall S Hestir, DDS
• Randi Carann Hestir, COTA-L

• Physical Therapy Clinic/Center in De Witt, AR
• Providers in De Witt, AR by specialty
• Physical Therapy Clinic/Center in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.