Organization Active NPI

Thrive Pediatric Physical Therapy

  • Pediatric Physical Therapist
  • Vicksburg, MS
National Provider Identifier
1427981984
Registry record updated Jun 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
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, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2026

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)CodeLicenseStatePrimary
Pediatric Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 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 Directory

Practitioners & 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.

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.

Verify at the official NPI Registry.