Active NPI
Elizabeth E Mink, DPT
- Physical Therapist
- Southaven, MS
National Provider Identifier
1508129941
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT5120
- Practice address
- 83 Airways PL
Southaven, MS 38671-5885 - Phone
- (662) 349-8787
- NPI assigned
- Jun 20, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT5120 | MS | Primary |
Addresses
Primary practice location
83 Airways PL
Southaven, MS 38671-5885
Mailing address
8940 Walnut Hill Rd Apt 302
Cordova, TN 38018-4834
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT5120 | MS | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1340150400000",
"number": "1508129941",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8940 WALNUT HILL RD APT 302",
"city": "CORDOVA",
"state": "TN",
"postal_code": "380184834"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "83 AIRWAYS PL",
"city": "SOUTHAVEN",
"state": "MS",
"postal_code": "386715885",
"telephone_number": "662-349-8787"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MINK",
"first_name": "ELIZABETH",
"middle_name": "E",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-06-20",
"last_updated": "2012-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MS",
"license": "PT5120",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southaven, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.