Individual provider Active NPI

Martha E Nance, PT, CWS

  • Physical Therapist
  • Flowood, MS
National Provider Identifier
1548346455
Registry record updated Jun 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT1300 Issued in MS
Practice address
104 Burney Dr
Flowood, MS 39232-6621
Phone
(601) 987-8202
Fax
(601) 718-0293
NPI assigned
Oct 31, 2006
Last updated
Jun 20, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2024

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 PT1300 MS Primary

Addresses

Primary practice location

104 Burney Dr
Flowood, MS 39232-6621

Mailing address

PO Box 30594
Charlotte, NC 28230-0594
Phone (601) 987-8202

Other identifiers 2

IdentifierTypeStateIssuer
200011205MedicaidMS
00123980MedicaidMS

Other names 1

  • Marti Nance Other name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
1300MSMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Capital Orthopaedic Clinic PLLC CurrentSince Mar 25, 2024 Accepting new patients
Capital Orthopaedic Clinic, PLLC CurrentSince Mar 25, 2024 Accepting new patients

Locations

119 Highway 80 E
Clinton, MS 39056
Phone (601) 708-1834

104 Burney Dr
Flowood, MS 39232
Phone (601) 987-8202

106 Highland Way
Ste 102
Madison, MS 39110

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1548346455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30594",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282300594",
            "telephone_number": "601-987-8202",
            "fax_number": "601-718-0293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 BURNEY DR",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392326621",
            "telephone_number": "601-987-8202",
            "fax_number": "601-718-0293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NANCE",
        "first_name": "MARTHA",
        "middle_name": "E",
        "credential": "PT, CWS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-31",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT1300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200011205",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00123980",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARTI",
            "last_name": "NANCE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Flowood, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2024; 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.