Jana B Burge
Individual provider Active NPI Physical Therapist · Picayune, MS
NPI 1356944094 · NPPES record last updated Nov 17, 2020
Key facts
- NPI
- 1356944094
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT7011 (MS)
- Practice address
- 110 Mitchell St
Picayune, MS 39466-4538 - Phone
- (601) 749-8145
- Fax
- (601) 749-8147
- NPI assigned
- Nov 17, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Picayune Physical Therapy Center
Practice addresses (Care Compare)
110 Mitchell St
Picayune, MS 39466-4538
Phone (601) 749-8145
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201222001005 | MS | Practitioner - Physical Therapist in Private Practice | 1052723707 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT7011 | MS | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT7011 | MS | Yes |
Addresses
Primary practice location
110 Mitchell St
Picayune, MS 39466-4538
Mailing address
110 Mitchell St
Picayune, MS 39466-4538
Phone (601) 749-8145
Other providers in Picayune, MS
- Dewitt L Bolton
- Deslie Bonano
- Kenneth Gerard Boutte Jr.
- Sara C Braddy
- Jefferson Buntin
- Tiffany Burnette
- Glenn A Butt
- Jessica Byrd
- Jennifer F Cacioppo
- John H. Campbell
All providers in Picayune, MS · Physical Therapist in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 17, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.