Medicomp, Inc

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

MEDICOMP, INC

Practice address

1112B Maria LN
Iuka, MS 38852-1119

Phone

(888) 976-2667

Fax

(601) 824-8828

NPI assigned

Apr 29, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Joseph McNulty III

Title

Ceo

Phone

(601) 849-6440

Specialties & licenses 1

Addresses

Other names 1

• Medicomp Physical Therapy Iuka Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Rollin Fair, DPT

  • Physical Therapist
  • Iuka, MS
  • NPI 1881071942
  NPD (past)

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

{
    "created_epoch": "1430265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430265600000",
    "number": "1457738429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2015 HIGHPOINTE DR",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390423169",
            "telephone_number": "888-976-2667",
            "fax_number": "601-824-8828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112B MARIA LN",
            "city": "IUKA",
            "state": "MS",
            "postal_code": "388521119",
            "telephone_number": "888-976-2667",
            "fax_number": "601-824-8828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICOMP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-29",
        "last_updated": "2015-04-29",
        "status": "A",
        "authorized_official_last_name": "MCNULTY",
        "authorized_official_first_name": "JOSEPH",
        "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": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medicomp Physical Therapy Iuka",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amy C McDeavitt
• Randy L McDuffy
• Brenton McKay, FNP
• Molly McLain, MSN, APRN, PMHNP-BC
• Brianna Meador
• Braxton Kye Meeks, FNP
• Midsouth Vision Service
• Mineral Springs Health Care,PLLC
• Mississippi State Department of Health
• Rhonda Vaught Mitchell

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2015; 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.