NPIMap

Organization Active NPI

Medicomp, Inc

Doing business as Dogwood Physical Therapy

  • Physical Therapist
  • Flowood, MS
National Provider Identifier
1407158454
Registry record updated Nov 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
MEDICOMP, INC
Doing business as
Dogwood Physical Therapy
Practice address
151 E Metro Dr
Suite 106
Flowood, MS 39232-4402
Phone
(601) 664-7191
Fax
(601) 664-7149
NPI assigned
Nov 24, 2010
Last updated
Nov 24, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2010

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

Authorized official

Name
Mr. Joseph S McNulty III
Title
Ceo
Phone
(601) 849-6440

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

151 E Metro Dr
Suite 106
Flowood, MS 39232-4402

Mailing address

151 E Metro Dr
Suite 106
Flowood, MS 39232-4402
Phone (601) 664-7191

Other identifiers 1

IdentifierTypeStateIssuer
09635221MedicaidMS

Other names 1

  • Dogwood Physical Therapy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Mediscan10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1290556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290556800000",
    "number": "1407158454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 E METRO DR",
            "address_2": "SUITE 106",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392324402",
            "telephone_number": "601-664-7191",
            "fax_number": "601-664-7149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 E METRO DR",
            "address_2": "SUITE 106",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392324402",
            "telephone_number": "601-664-7191",
            "fax_number": "601-664-7149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICOMP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-24",
        "last_updated": "2010-11-24",
        "status": "A",
        "authorized_official_last_name": "MCNULTY",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "601-849-6440",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09635221",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dogwood Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Flowood, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2010; 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.