Momentum Therapy Services of Mississippi LLC

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Legal business name

MOMENTUM THERAPY SERVICES OF MISSISSIPPI LLC

Practice address

532 Kavanaugh Dr
Vicksburg, MS 39180-4566

Phone

(601) 954-7708

NPI assigned

Apr 18, 2025

Last updated

Apr 18, 2025By 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. Heather GreenNPI 1033821319

Title

Owner

Phone

(601) 954-7708

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Heather Ann Green, OTR/L

  • Occupational Therapist
  • Vicksburg, MS
  • NPI 1033821319
  NPD Authorized official

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

{
    "created_epoch": "1744934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744934400000",
    "number": "1346036803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "532 KAVANAUGH DR",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391804566",
            "telephone_number": "601-954-7708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "532 KAVANAUGH DR",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391804566",
            "telephone_number": "601-954-7708"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "532 Kavanaugh Dr",
            "address_purpose": "LOCATION",
            "city": "Vicksburg",
            "state": "MS",
            "postal_code": "391804566",
            "country_code": "US",
            "telephone_number": "601-954-7708",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MOMENTUM THERAPY SERVICES OF MISSISSIPPI LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-18",
        "last_updated": "2025-04-18",
        "certification_date": "2025-04-18",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-954-7708",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mississippi Homecare, LLC
• Mississippi State Department of Health
• Brandon Mizell, M.D.
• Alyssa Moncrief Smith
• Roxane Theresa Moncure, AGNP
• Ronnie Monsour
• Moore Counseling and Consultation Services LLC
• Christine Moore

• Occupational Therapist in Vicksburg, MS
• Providers in Vicksburg, MS by specialty
• Occupational Therapist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2025; 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.