Advanced Physical Therapy, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

ADVANCED PHYSICAL THERAPY, LLC

Practice address

6399 Goodman Rd
Suite 108
Olive Branch, MS 38654-7070

Phone

(901) 652-0413

NPI assigned

Mar 28, 2012

Organization subpart

No

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

Authorized official

Name

Marcus Shannon King, PT, ATC/LATNPI 1811930134

Title

Sole Member, Physical Therapist

Phone

(901) 652-0413

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Locations

Practitioners 2

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

• Marcus Shannon King, PT ATC LAT

  • Physical Therapist
  • Olive Branch, MS
  • NPI 1811930134
  Medicare reassignment NPD Authorized official
• Makenzie Paige Crutcher, DPT

  • Physical Therapist
  • Olive Branch, MS
  • NPI 1164295622
  NPD (past)

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

{
    "created_epoch": "1332892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736380800000",
    "number": "1467728006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6399 GOODMAN RD",
            "address_2": "SUITE 108",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386547070",
            "telephone_number": "901-652-0413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6399 GOODMAN RD",
            "address_2": "SUITE 108",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386547070",
            "telephone_number": "901-652-0413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-28",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "MARCUS",
        "authorized_official_middle_name": "SHANNON",
        "authorized_official_title_or_position": "SOLE MEMBER, PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "901-652-0413",
        "authorized_official_credential": "PT, ATC/LAT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Glenn Allen Adair, R.P.H.
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• Christi Adams, PHARM D.
• Amber Sadae Adell, AGACNP-BC
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• Kelsey Agnew, SLPD, CCC-SLP

• Physical Therapy Clinic/Center in Olive Branch, MS
• Providers in Olive Branch, MS by specialty
• Physical Therapy Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.