Active NPI
Amy Green, DPT
- Physical Therapist
- Vicksburg, MS
National Provider Identifier
1306263793
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT4965
- Practice address
- 1901-A Mission 66
Vicksburg, MS 39180 - Phone
- (601) 638-4076
- NPI assigned
- Mar 24, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT4965 | MS | Primary |
Addresses
Primary practice location
1901-A Mission 66
Vicksburg, MS 39180
Mailing address
PO Box 822394
Vicksburg, MS 39182-2394
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1395619200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1395619200000",
"number": "1306263793",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 822394",
"city": "VICKSBURG",
"state": "MS",
"postal_code": "391822394"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1901-A MISSION 66",
"city": "VICKSBURG",
"state": "MS",
"postal_code": "39180",
"telephone_number": "601-638-4076"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "AMY",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-03-24",
"last_updated": "2014-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MS",
"license": "PT4965",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vicksburg, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.