NPIMap

Organization Active NPI

PT Company

  • Physical Therapist
  • Dyersburg, TN
National Provider Identifier
1508532698
Registry record updated Aug 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PT COMPANY
Practice address
1400 Shelby Dr
Dyersburg, TN 38024-3435
Phone
(731) 288-5056
Fax
(731) 288-5067
NPI assigned
Aug 18, 2021
Last updated
Aug 18, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2021

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

Authorized official

Name
Misty Jackson
Title
Office Manager
Phone
(731) 288-5056

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

1400 Shelby Dr
Dyersburg, TN 38024-3435

Mailing address

1400 Shelby Dr
Dyersburg, TN 38024-3435
Phone (731) 288-5056

Other practice location 1

102 S Court St
Tiptonville, TN 38079-1304
Phone (731) 253-9020

Other practice location 2

1800 Truman Blvd
Caruthersville, MO 63830-2425
Phone (573) 333-9944

National Provider Directory

National Provider Directory

Locations

1400 Shelby Dr
Dyersburg, TN 38024
Phone (731) 288-5056

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1629244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629244800000",
    "number": "1508532698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 SHELBY DR",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "380243435",
            "telephone_number": "731-288-5056",
            "fax_number": "731-288-5067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 SHELBY DR",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "380243435",
            "telephone_number": "731-288-5056",
            "fax_number": "731-288-5067"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "102 S Court St",
            "address_purpose": "LOCATION",
            "city": "Tiptonville",
            "state": "TN",
            "postal_code": "380791304",
            "country_code": "US",
            "telephone_number": "731-253-9020",
            "fax_number": "731-253-9050",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1800 Truman Blvd",
            "address_purpose": "LOCATION",
            "city": "Caruthersville",
            "state": "MO",
            "postal_code": "638302425",
            "country_code": "US",
            "telephone_number": "573-333-9944",
            "fax_number": "731-288-5067",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PT COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-18",
        "last_updated": "2021-08-18",
        "certification_date": "2021-07-27",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "MISTY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "731-288-5056"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dyersburg, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2021; 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.