Individual provider Active NPI

Bailey T Bynum, DPT

  • Physical Therapist
  • Laurel, MS
National Provider Identifier
1558090225
Registry record updated Dec 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
7320 Issued in MS
Practice address
1707 W 20TH St
Laurel, MS 39440-1802
Phone
(601) 428-2004
Fax
(601) 428-8833
NPI assigned
Jun 8, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2025

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 7320 MS Primary

Addresses

Primary practice location

1707 W 20TH St
Laurel, MS 39440-1802

Mailing address

1707 W 20TH St
Laurel, MS 39440-1802
Phone (601) 428-2004

Other identifiers 2

IdentifierTypeStateIssuer
200005097MedicaidMS
200024732MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230815000550 MS Practitioner - Physical Therapist in Private Practice 8729440342 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Mississippi School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peak Physical Therapy LLCGroup PAC ID 2769997287, 5 clinicians

Practice addresses (Care Compare)

1707 W 20TH St
Laurel, MS 39440-1802
Phone (601) 428-2004

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7320MSMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Peak Physical Therapy, LLC Physical Therapist CurrentSince Jun 1, 2025 Accepting new patients
Gptrs II Physical Therapist CurrentSince Apr 7, 2023 Accepting new patients

Locations

1707 W 20th St
Laurel, MS 39440
Phone (601) 428-2004

308 Corporate Dr
Ridgeland, MS 39157
Phone (601) 898-7500

227 Highway 51
Ridgeland, MS 39157
Phone (601) 898-4324

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1654646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765238400000",
    "number": "1558090225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1707 W 20TH ST",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394401802",
            "telephone_number": "601-428-2004",
            "fax_number": "601-428-8833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1707 W 20TH ST",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394401802",
            "telephone_number": "601-428-2004",
            "fax_number": "601-428-8833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BYNUM",
        "first_name": "BAILEY",
        "middle_name": "T",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-08",
        "last_updated": "2025-12-09",
        "certification_date": "2025-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "7320",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200005097",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200024732",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.