Individual provider Active NPI

Kaylee Davis Musselwhite, PT, DPT

  • Physical Therapist
  • Waycross, GA
National Provider Identifier
1558898692
Registry record updated May 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT011923 Issued in GA
Practice address
2267 Memorial Dr Ste 300
Waycross, GA 31501-0902
Phone
(912) 285-1927
Fax
(912) 285-1929
NPI assigned
May 19, 2017
Last updated
May 19, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2017

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 PT011923 GA Primary

Addresses

Primary practice location

2267 Memorial Dr Ste 300
Waycross, GA 31501-0902

Mailing address

8823 Production LN
Ooltewah, TN 37363-6511
Phone (423) 238-7217

Other names 1

  • Kaylee R Davis Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170718000782 GA Practitioner - Physical Therapist in Private Practice 5092085480 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT011923GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Speech Clinic LLC CurrentSince Oct 1, 2022 Accepting new patients
Independent Physical Therapy of Ga, LLC Physical Therapist Past Accepting new patients
Speech-Language Pathology Contractors, Inc. PastSince Oct 1, 2022 Accepting new patients

Locations

1507 Alice St
Waycross, GA 31501
Phone (912) 283-7220

303 Pineview Dr
Waycross, GA 31501
Phone (912) 283-0777

Organizations & group practices 3

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": "1495152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1495152000000",
    "number": "1558898692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8823 PRODUCTION LN",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373636511",
            "telephone_number": "423-238-7217",
            "fax_number": "423-362-8684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2267 MEMORIAL DR STE 300",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315010902",
            "telephone_number": "912-285-1927",
            "fax_number": "912-285-1929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSSELWHITE",
        "first_name": "KAYLEE",
        "middle_name": "DAVIS",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-19",
        "last_updated": "2017-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT011923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAYLEE",
            "last_name": "DAVIS",
            "middle_name": "R",
            "credential": "PT, DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Waycross, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.