NPIMap

Organization Active NPI

Sports Therapy Center

  • Physical Therapist
  • Flowood, MS
National Provider Identifier
1508078809
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT1265 Issued in MS
Legal business name
SPORTS THERAPY CENTER
Practice address
201 E Layfair Dr
Ste 125
Flowood, MS 39232-7604
Phone
(601) 420-6867
Fax
(601) 664-1006
NPI assigned
May 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Renae Upton
Title
Office Manager
Phone
(601) 420-6867

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X PT1265 MS Primary

Addresses

Primary practice location

201 E Layfair Dr
Ste 125
Flowood, MS 39232-7604

Mailing address

201 E Layfair Dr
Ste 125
Flowood, MS 39232-7604
Phone (601) 420-6867

National Provider Directory

National Provider Directory
Tax ID family
Sports Therapy Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

201 E Layfair Dr
Ste 125
Flowood, MS 39232
Phone (601) 420-6867

Practitioners & affiliated clinicians

Practitioners 5

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": "1178496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508078809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E LAYFAIR DR",
            "address_2": "STE 125",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392327604",
            "telephone_number": "601-420-6867",
            "fax_number": "601-664-1006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E LAYFAIR DR",
            "address_2": "STE 125",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392327604",
            "telephone_number": "601-420-6867",
            "fax_number": "601-664-1006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORTS THERAPY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "UPTON",
        "authorized_official_first_name": "RENAE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "601-420-6867"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT1265",
            "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 Aug 22, 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.

Verify at the official NPI Registry.