Capitol Physical Therapy, PA

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT0223 Issued in MS

Legal business name

CAPITOL PHYSICAL THERAPY, PA

Practice address

2648 Ridgewood Rd
Suite a
Jackson, MS 39216-4903

Phone

(601) 366-1456

Fax

(601) 366-1448

NPI assigned

May 23, 2007

Last updated

Mar 17, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Charles Benford, P.T.NPI 1780715854

Title

President

Phone

(601) 978-1798

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

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.

• Charles A Benford Sr., P.T.

  • Physical Therapist
  • Jackson, MS
  • NPI 1780715854
  Authorized official Same address or phone
• Sherrice Benford, PTA

  • Physical Therapy Assistant
  • Jackson, MS
  • NPI 1972261048
  NPD

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679011200000",
    "number": "1518177971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5888 RIDGEWOOD RD STE B",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392112644",
            "telephone_number": "601-978-1798",
            "fax_number": "601-978-1799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2648 RIDGEWOOD RD",
            "address_2": "SUITE A",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164903",
            "telephone_number": "601-366-1456",
            "fax_number": "601-366-1448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPITOL PHYSICAL THERAPY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2023-03-17",
        "certification_date": "2023-03-17",
        "status": "A",
        "authorized_official_last_name": "BENFORD",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "601-978-1798",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT0223",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05855578",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Jackson, MS
• Providers in Jackson, MS by specialty
• Physical Therapist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2023; 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.