Individual provider Active NPI

Ryan Mathis Shotts, DPT

  • Physical Therapist
  • Amory, MS
National Provider Identifier
1588131106
Registry record updated Nov 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT6457 Issued in MS
Practice address
1111 Earl Frye Blvd
Amory, MS 38821-5516
Phone
(662) 257-4048
Fax
(662) 257-4080
NPI assigned
Nov 1, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2018

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 PT6457 MS Primary

Addresses

Primary practice location

1111 Earl Frye Blvd
Amory, MS 38821-5516

Mailing address

199 N Brookmoore Dr
Columbus, MS 39705-2024
Phone (662) 327-6705

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181203000200 MS Practitioner - Physical Therapist in Private Practice 8729322714 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Drayer Physical Therapy Mississippi LLCGroup PAC ID 3274834858, 113 clinicians

Practice addresses (Care Compare)

1111 Earl Frye Blvd
Amory, MS 38821-5516
Phone (662) 257-4048

17 County Rd
Suite 535
Corinth, MS 38834-8112
Phone (662) 418-4350

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT6457MSMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Shotts Therapy LLC Physical Therapist CurrentSince Oct 28, 2024 Accepting new patients
Dpti Elite Physical Therapy LLC Physical Therapist Current Accepting new patients
Drayer Physical Therapy Mississippi LLC Physical Therapist CurrentSince Jun 12, 2018 Accepting new patients
Dpti Elite Physical Therapy LLC Physical Therapist CurrentSince Jun 12, 2018 Accepting new patients
Drayer Physical Therapy Mississippi LLC Physical Therapist Past Accepting new patients
Specialty Orthopedic Group of Mississippi PLLC PastSince Mar 18, 2019 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

1111 Earl Frye Blvd
Amory, MS 38821
Phone (662) 256-6002

413 N 2nd St
Booneville, MS 38829
Phone (662) 480-4006

199 N Brookmoore Dr
Columbus, MS 39705
Phone (662) 798-0108

117 Bo Bo Dr
Crystal Springs, MS 39059
Phone (601) 892-6330

2319 Highway 145
Saltillo, MS 38866
Phone (662) 869-9980

Organizations & group practices 6

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": "1541030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541030400000",
    "number": "1588131106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "199 N BROOKMOORE DR",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "397052024",
            "telephone_number": "662-327-6705",
            "fax_number": "662-327-6760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 EARL FRYE BLVD",
            "city": "AMORY",
            "state": "MS",
            "postal_code": "388215516",
            "telephone_number": "662-257-4048",
            "fax_number": "662-257-4080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOTTS",
        "first_name": "RYAN",
        "middle_name": "MATHIS",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-01",
        "last_updated": "2018-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT6457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amory, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2018; 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.