Individual provider Active NPI

Lorry King, PT

  • Physical Therapist
  • Cleveland, MS
National Provider Identifier
1508913229
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT1686 Issued in MS
Practice address
1000 S Fifth Ave
Cleveland, MS 38732-3626
Phone
(662) 843-2339
Fax
(662) 846-1397
NPI assigned
Jan 4, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT1686 MS Primary

Addresses

Primary practice location

1000 S Fifth Ave
Cleveland, MS 38732-3626

Mailing address

1000 S Fifth Ave
Cleveland, MS 38732-3626
Phone (662) 843-2339

Other identifiers 1

IdentifierTypeStateIssuer
09532359MedicaidMS

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

LicenseStateTypeSpecialty
PT1686MSMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1508913229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 S FIFTH AVE",
            "city": "CLEVELAND",
            "state": "MS",
            "postal_code": "387323626",
            "telephone_number": "662-843-2339",
            "fax_number": "662-846-1397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 S FIFTH AVE",
            "city": "CLEVELAND",
            "state": "MS",
            "postal_code": "387323626",
            "telephone_number": "662-843-2339",
            "fax_number": "662-846-1397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "LORRY",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-04",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT1686",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09532359",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.