First Place Physical Therapy LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

PT0549 Issued in MS

Legal business name

FIRST PLACE PHYSICAL THERAPY LLC

Practice address

433 Broad St
Columbia, MS 39429-3038

Phone

(601) 444-0030

Fax

(601) 444-0033

NPI assigned

Nov 13, 2006

Last updated

Aug 22, 2020By 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

Carroll Edward Brown, PT OCSNPI 1235177064

Title

Owner Therapist

Phone

(601) 444-0030

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1356412803. Details of each certification follow.

• CCN 256586 Outpatient physical therapy / speech pathology · Active · Name & address match · Details

Outpatient physical therapy / speech pathology certification: CCN 256586

Legal name

FIRST PLACE PHYSICAL THERAPY

Certification status

Active

Provider type (POS)

Outpatient physical therapy / speech pathology

Participating since

Jan 23, 2002

Last certification

May 6, 2021

Ownership / control type

Proprietary

Facility address

433 Broad Street
Columbia, MS 39429

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.

• Carroll E. Brown, PT

  • Physical Therapist
  • Hattiesburg, MS
  • NPI 1235177064
  NPD Authorized official

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1356412803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "433 BROAD ST",
            "city": "COLUMBIA",
            "state": "MS",
            "postal_code": "394293038",
            "telephone_number": "601-444-0030",
            "fax_number": "601-444-0033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 BROAD ST",
            "city": "COLUMBIA",
            "state": "MS",
            "postal_code": "394293038",
            "telephone_number": "601-444-0030",
            "fax_number": "601-444-0033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST PLACE PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "CARROLL",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "OWNER THERAPIST",
        "authorized_official_telephone_number": "601-444-0030",
        "authorized_official_credential": "PT OCS"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MS",
            "license": "PT0549",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06231289",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Forrest County General Hospital (Marion General Hospital)
• Forrest County General Hospital (Marion County Surgical Clinic)
• Forrest County General Hospital (Marion General Hospital)
• Forrest County General Hospital (Forrest General Home Care of Marion General)
• Forrest County General Hospital (Marion General Hospital)

• Physical Therapy Clinic/Center in Columbia, MS
• Providers in Columbia, MS by specialty
• Physical Therapy Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.