V a North

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT2019 Issued in MS

Legal business name

V A NORTH

Doing business as

V a North

Practice address

500 W County Line Rd
Tougaloo, MS 39174-9700

Phone

(601) 636-6019

Fax

(601) 661-8457

NPI assigned

Dec 14, 2006

Last updated

Sep 11, 2025By 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. Terrence D Nickens, PT

Title

Owner

Phone

(601) 636-6019

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• V A NORTH Doing business as

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1548322951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3183",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391583183",
            "telephone_number": "601-636-6019",
            "fax_number": "601-661-8457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W COUNTY LINE RD",
            "city": "TOUGALOO",
            "state": "MS",
            "postal_code": "391749700",
            "telephone_number": "601-636-6019",
            "fax_number": "601-661-8457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "V A NORTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-14",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "NICKENS",
        "authorized_official_first_name": "TERRENCE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-636-6019",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT3573",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MS",
            "license": "OT2019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02900724",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "V A NORTH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Occupational Therapist in Tougaloo, MS
• Providers in Tougaloo, MS by specialty
• Occupational Therapist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.