Tara D King

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT5382 Issued in MS

Practice address

1325 E Fortification St
Jackson, MS 39202-2442

Phone

(601) 949-9106

Fax

(601) 914-1835

NPI assigned

Mar 7, 2014

Last updated

Mar 7, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Tara Davis Other name

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mississippi Spine and Pelvic Health Physical Therapy LLCGroup PAC ID 8325436884, 14 clinicians

Mississippi Sports Medicine and Orthopaedic CenterGroup PAC ID 4981685310, 67 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Mississippi Spine and Pelvic Health Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Ridgeland, MS
  • NPI 1710654686

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Mississippi Sports Medicine & Orthopaedic Center

  • Orthopaedic Surgery Physician
  • Jackson, MS
  • NPI 1568415560
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1394150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394150400000",
    "number": "1437575990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 E FORTIFICATION ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022442",
            "telephone_number": "601-949-9106",
            "fax_number": "601-914-1835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 E FORTIFICATION ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022442",
            "telephone_number": "601-949-9106",
            "fax_number": "601-914-1835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "TARA",
        "middle_name": "D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-07",
        "last_updated": "2014-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT5382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARA",
            "last_name": "DAVIS",
            "credential": "PT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jordan King, MD
• Melissa King, NP
• Rachel Leggett King, PMHNP
• Riley Corbin King, DO
• Shernise King
• Timothy Hunter King, MD
• Zachary King
• Kingdom Covenant Care, LLC
• Caleb James Kingma
• Kelton Kingsley, MD

• 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 Mar 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.