Individual provider Active NPI

Joshua D Duckworth

  • Physical Therapist
  • Magee, MS
National Provider Identifier
1467775767
Registry record updated Mar 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT4533 Issued in MS
Practice address
110 Pioneer Way
Magee, MS 39111-0000
Phone
(601) 849-1682
Fax
(601) 849-1969
NPI assigned
Mar 2, 2010
Last updated
Mar 2, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT4533 MS Primary

Addresses

Primary practice location

110 Pioneer Way
Magee, MS 39111-0000

Mailing address

110 Pioneer Way
Magee, MS 39111-0000
Phone (601) 849-1682

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100920000761 MS Practitioner - Physical Therapist in Private Practice 8022133602 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
2083 Therapy, LLCGroup PAC ID 4082976246, 11 clinicians

Practice addresses (Care Compare)

710 Main St
Collins, MS 39428-6292
Phone (601) 340-6872

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
2083 Therapy, LLC Physical Therapist Current Accepting new patients
2083 Therapy, LLC CurrentSince Mar 5, 2018 Accepting new patients
2083 Therapy, LLC CurrentSince Mar 5, 2018 Accepting new patients
Enduracare Acute Care Services LLC Physical Therapist Past Accepting new patients

Locations

710 Main St
Collins, MS 39428
Phone (601) 340-6872

1151 Highway 35 S
Forest, MS 39074
Phone (601) 469-2732

110 Pioneer Way
Magee, MS 39111

357 Simpson Highway 149
Magee, MS 39111
Phone (601) 849-2734

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1267488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267488000000",
    "number": "1467775767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 PIONEER WAY",
            "city": "MAGEE",
            "state": "MS",
            "postal_code": "391110000",
            "telephone_number": "601-849-1682",
            "fax_number": "601-849-1969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 PIONEER WAY",
            "city": "MAGEE",
            "state": "MS",
            "postal_code": "391110000",
            "telephone_number": "601-849-1682",
            "fax_number": "601-849-1969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUCKWORTH",
        "first_name": "JOSHUA",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-02",
        "last_updated": "2010-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT4533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Magee, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2010; 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.