Active NPI
Thrive Pediatric Physical Therapy
- Pediatric Physical Therapist
- Vicksburg, MS
National Provider Identifier
1427981984
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- Legal business name
- THRIVE PEDIATRIC PHYSICAL THERAPY
- Practice address
- 2023 Warriors TRL
Vicksburg, MS 39180-7764 - Phone
- (601) 415-9530
- NPI assigned
- Jun 4, 2026
- Last updated
- Jun 4, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Sandy Kay Raines, PT
- Title
- Physical Therapist
- Phone
- (601) 415-9530
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | Primary |
Addresses
Primary practice location
2023 Warriors TRL
Vicksburg, MS 39180-7764
Mailing address
2023 Warriors TRL
Vicksburg, MS 39180-7764
Phone (601) 415-9530
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
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.
-
- Physical Therapist
- Vicksburg, MS
- NPI 1215670112
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1780531200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1780531200000",
"number": "1427981984",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2023 WARRIORS TRL",
"city": "VICKSBURG",
"state": "MS",
"postal_code": "391807764",
"telephone_number": "601-415-9530"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2023 WARRIORS TRL",
"city": "VICKSBURG",
"state": "MS",
"postal_code": "391807764",
"telephone_number": "601-415-9530"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "THRIVE PEDIATRIC PHYSICAL THERAPY",
"organizational_subpart": "NO",
"enumeration_date": "2026-06-04",
"last_updated": "2026-06-04",
"certification_date": "2026-06-04",
"status": "A",
"authorized_official_last_name": "RAINES",
"authorized_official_first_name": "SANDY",
"authorized_official_middle_name": "KAY",
"authorized_official_title_or_position": "PHYSICAL THERAPIST",
"authorized_official_telephone_number": "601-415-9530",
"authorized_official_credential": "PT"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Therapist, Pediatrics",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Vicksburg, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.