Philip Massey

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C7217 Issued in MS

Practice address

5345 Highway 18 W
Jackson, MS 39209-9421

Phone

(601) 927-0188

Fax

(601) 292-7998

NPI assigned

Nov 17, 2014

Last updated

Sep 11, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS, WI2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Clinical Social Worker

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Urban Rehab, IncGroup PAC ID 7012214638, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Urban Rehab, Inc

  dba UR, Incorporated

  • Clinical Social Worker
  • Clinton, MS
  • NPI 1417370313

  Addiction (Substance Use Disorder), WI

  Medicare reassignment Care Compare group NPD Authorized official
• Urban Rehab, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Clinton, MS
  • NPI 1003469743
  NPD Authorized official
• The Center of Care LLC

  • Adolescent and Children Mental Health Clinic/Center
  • Clinton, MS
  • NPI 1558998799
  Authorized official Same address or phone

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

{
    "created_epoch": "1416182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694390400000",
    "number": "1306242458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2305",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "390602305",
            "telephone_number": "601-272-2202",
            "fax_number": "601-292-7998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5345 HIGHWAY 18 W",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392099421",
            "telephone_number": "601-927-0188",
            "fax_number": "601-292-7998"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3450 Highway 80 W",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "392097201",
            "country_code": "US",
            "telephone_number": "601-321-2400",
            "fax_number": "601-321-2476",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "901 Highway 80 E",
            "address_purpose": "LOCATION",
            "city": "Clinton",
            "state": "MS",
            "postal_code": "39056",
            "country_code": "US",
            "telephone_number": "601-927-0188 x101",
            "fax_number": "601-292-7998",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MASSEY",
        "first_name": "PHILIP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-11-17",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MS",
            "license": "AD07-046M",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MS",
            "license": "M7217",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MS",
            "license": "C7217",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05671221",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Massage Revolution
• Massage Revolution
• John Lloyd Massey III, OTR/L
• Nellie Joann Massey
• Pamela S Massey, CFNP
• Paul Bernard Matens, LCSW
• Sara Matheson
• Tricia Roy Mathias, R.D.
• Sara Taylor Mathis
• Matthews Chiropractic Clinic

• Clinical Social Worker in Jackson, MS
• Providers in Jackson, MS by specialty
• Clinical Social Worker in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.