NPIMap

Individual provider Active NPI

Melissa D. Leonard, PT

  • Pediatric Physical Therapist
  • Southaven, MS
National Provider Identifier
1609109164
Registry record updated Sep 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
PT4623 Issued in MS
Practice address
7160 Tchulahoma Rd
Southaven, MS 38671-9266
Phone
(662) 349-2733
NPI assigned
Sep 15, 2009
Sex
Female
Sole proprietor
No

Organizations & group practices 28

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.

View all 28

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aegis Group Practice LLC 399 clinicians

Practice addresses (Care Compare)

601 Wolf River Blvd
Collierville, TN 38017-6600
Phone (901) 883-0348

9684 Goodman Rd
Olive Branch, MS 38654-1726
Phone (662) 880-3334

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MS2 enrollments

Medicare enrollment records 2

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20141218001398 TN Practitioner - Physical Therapist in Private Practice 7719200989 Reassigns benefits to 2 organizations
I20230516002154 MS Practitioner - Physical Therapist in Private Practice 7719200989 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Creative Health Care Management LLC CurrentSince Apr 1, 2023 Accepting new patients
Fox Rehabilitation Services TN LLC Pediatrics CurrentSince Mar 12, 2025 Accepting new patients
Creative Health Care Management LLC Pediatrics CurrentSince Apr 1, 2023 Accepting new patients
Fox Rehab Agency Ms LLC CurrentSince Jan 1, 2025 Accepting new patients

Locations

10 S 9th St
Ste 4
Noblesville, IN 46060

6600 Poplar Springs Dr
Meridian, MS 39305
Phone (601) 482-5561

74 Claiborne Way
Starkville, MS 39759
Phone (662) 268-9555

7 Carnegie Plz
Cherry Hill, NJ 08003

3056 Miles Johnson Pkwy
Spring Hill, TN 37174
Phone (931) 451-0009

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X PT4623 MS Primary

Addresses

NPPES NPI Registry

Primary practice location

7160 Tchulahoma Rd
Southaven, MS 38671-9266

Mailing address

7160 Tchulahoma Road
Southaven, MS 38671
Phone (662) 349-2733

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
PT4623OtherMSMS

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 15, 2009.

{
    "created_epoch": "1252972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252972800000",
    "number": "1609109164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7160 TCHULAHOMA ROAD",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "38671",
            "telephone_number": "662-349-2733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7160 TCHULAHOMA RD",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386719266",
            "telephone_number": "662-349-2733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEONARD",
        "first_name": "MELISSA",
        "middle_name": "D.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-15",
        "last_updated": "2009-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "MS",
            "license": "PT4623",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MS",
            "identifier": "PT4623",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southaven, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2009; 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.