Scotty W. Grantham, R.P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT3612 Issued in MS

Practice address

5250 Galaxie Dr
Suite K
Jackson, MS 39206-4311

Phone

(601) 368-4570

Fax

(601) 368-4571

NPI assigned

Oct 19, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Better Care Home Therapy, LLC

  • Physical Therapist
  • Jackson, MS
  • NPI 1508882606
  NPD (past)
• Biogenics, LLC

  • Clinic/Center
  • Brandon, MS
  • NPI 1821477167
  NPD (past)

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366524464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5250 GALAXIE DR",
            "address_2": "SUITE K",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392064311",
            "telephone_number": "601-368-4570",
            "fax_number": "601-368-4571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5250 GALAXIE DR",
            "address_2": "SUITE K",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392064311",
            "telephone_number": "601-368-4570",
            "fax_number": "601-368-4571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANTHAM",
        "first_name": "SCOTTY",
        "middle_name": "W.",
        "name_prefix": "Mr.",
        "credential": "R.P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT3612",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY LICENSE",
            "identifier": "PT3612",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan L Graning, CRNA
• Dana Lanell Grant, M.D.
• Janie Mae Grant, RN
• Olivia Harlan Grant, MD
• Tiffani L Grant, LD
• Grassroots Therapy Solutions LLC
• Kim L. Gratz, PH.D.
• Mary K Gravel, CRNA
• Glen Robert Graves, M.D.
• Lauren Baillie Graves, PH.D.

• Physical Therapist in Jackson, MS
• Providers in Jackson, MS by specialty
• Physical Therapist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.