Joshua D Duckworth
Individual provider Active NPI Physical Therapist · Magee, MS
NPI 1467775767 · NPPES record last updated Mar 2, 2010
Key facts
- NPI
- 1467775767
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT4533 (MS)
- Practice address
- 110 Pioneer Way
Magee, MS 39111-0000 - Phone
- (601) 849-1682
- Fax
- (601) 849-1969
- NPI assigned
- Mar 2, 2010
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- 2083 Therapy, LLC
Practice addresses (Care Compare)
710 Main St
Collins, MS 39428-6292
Phone (601) 340-6872
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100920000761 | MS | Practitioner - Physical Therapist in Private Practice | 8022133602 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT4533 | MS | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| 2083 Therapy, LLC | Current |
Accepting new patients | |
| 2083 Therapy, LLC | Physical Therapist | Current | Accepting new patients |
| 2083 Therapy, LLC | Current |
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
357 Simpson Highway 149
Magee, MS 39111
Phone (601) 849-2734
110 Pioneer Way
Magee, MS 39111
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT4533 | MS | Yes |
Addresses
Primary practice location
110 Pioneer Way
Magee, MS 39111-0000
Mailing address
110 Pioneer Way
Magee, MS 39111-0000
Phone (601) 849-1682
Other providers in Magee, MS
- Heather Davis
- Dental Group of Magee PLLC
- DM and C
- Doctor Jack R Magee DMD PA
- Harry Lee Dowdy
- Natalie K Duckworth
- Teresa T Duckworth
- Echols Family Eye Care
- Kandice Echols
- Makayla B Eiland
All providers in Magee, MS · Physical Therapist in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 2, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.