Active NPI
Joseph Harris
- Physical Therapist
- Flowood, MS
National Provider Identifier
1457979361
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT1158
- Practice address
- 4215 Lakeland Dr
Flowood, MS 39232-9212 - Phone
- (601) 932-8555
- NPI assigned
- Jul 7, 2020
- Last updated
- Jul 7, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT1158 | MS | Primary |
Addresses
Primary practice location
4215 Lakeland Dr
Flowood, MS 39232-9212
Mailing address
711 Avignon Dr
Ridgeland, MS 39157-5120
Phone (601) 605-6777
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT1158 | MS | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mid South Rehab Outpatient Clinic LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba 360 Total Rehab
- Physical Therapy Clinic/Center
- Jackson, TN
- NPI 1265977847
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1594080000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1594080000000",
"number": "1457979361",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "711 AVIGNON DR",
"city": "RIDGELAND",
"state": "MS",
"postal_code": "391575120",
"telephone_number": "601-605-6777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4215 LAKELAND DR",
"city": "FLOWOOD",
"state": "MS",
"postal_code": "392329212",
"telephone_number": "601-932-8555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "JOSEPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-07-07",
"last_updated": "2020-07-07",
"certification_date": "2020-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MS",
"license": "PT1158",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Jul 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.