Active NPI
Charles M Remus
- Physical Therapy Assistant
- Jackson, MS
National Provider Identifier
1326412289
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- PTA4425
- Practice address
- 1200 N State St
Suite 500
Jackson, MS 39202-2000 - Phone
- (601) 352-2273
- Fax
- (601) 714-3415
- NPI assigned
- Nov 16, 2015
- Sex
- Male
- 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 Therapy Assistant | 225200000X | PTA4425 | MS | Primary |
Addresses
Primary practice location
1200 N State St
Suite 500
Jackson, MS 39202-2000
Mailing address
1600 N State St
Suite 400
Jackson, MS 39202-1689
Phone (601) 944-1717
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PENDING | Other | BCBS |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTA4425 | MS | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1447632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447632000000",
"number": "1326412289",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1600 N STATE ST",
"address_2": "SUITE 400",
"city": "JACKSON",
"state": "MS",
"postal_code": "392021689",
"telephone_number": "601-944-1717",
"fax_number": "601-944-9780"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 N STATE ST",
"address_2": "SUITE 500",
"city": "JACKSON",
"state": "MS",
"postal_code": "392022000",
"telephone_number": "601-352-2273",
"fax_number": "601-714-3415"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REMUS",
"first_name": "CHARLES",
"middle_name": "M",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-11-16",
"last_updated": "2015-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "MS",
"license": "PTA4425",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "PENDING",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Jackson, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.