NPIMap

Organization Active NPI

Starkville Physical Therapy, Inc.

  • Physical Therapist
  • Starkville, MS
National Provider Identifier
1497948152
Registry record updated Aug 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 1169 Issued in MS
Legal business name
STARKVILLE PHYSICAL THERAPY, INC.
Practice address
100B4 GT Thames Drive
Starkville, MS 39759-8836
Phone
(662) 615-1870
Fax
(662) 615-1871
NPI assigned
Aug 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2007

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

Authorized official

Name
Mrs. Hilary H Rendon, PT
Title
President
Phone
(662) 615-1870

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X PT 1169 MS Primary

Addresses

Primary practice location

100B4 GT Thames Drive
Starkville, MS 39759-8836

Mailing address

100B4 GT Thames Drive
Starkville, MS 39759-8836
Phone (662) 615-1870

Other names 1

  • Starkville Physical Therapy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071017000053 MS Part B Supplier - Clinic/Group Practice 5395831770 Receives reassigned benefits from 1 practitioner
Practice locations: Starkville, MS

National Provider Directory

National Provider Directory

Locations

100 G T Thames Dr
Ste B
Starkville, MS 39759

100B4 G T Thames Dr
Starkville, MS 39759
Phone (662) 615-1870

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1187913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187913600000",
    "number": "1497948152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100B4 GT THAMES DRIVE",
            "city": "STARKVILLE",
            "state": "MS",
            "postal_code": "397598836",
            "telephone_number": "662-615-1870",
            "fax_number": "662-615-1871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100B4 GT THAMES DRIVE",
            "city": "STARKVILLE",
            "state": "MS",
            "postal_code": "397598836",
            "telephone_number": "662-615-1870",
            "fax_number": "662-615-1871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STARKVILLE PHYSICAL THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-24",
        "last_updated": "2007-08-24",
        "status": "A",
        "authorized_official_last_name": "RENDON",
        "authorized_official_first_name": "HILARY",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "662-615-1870",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT 1169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Starkville Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Starkville, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2007; 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.