NPIMap

Organization Active NPI

PT Company

  • Physical Therapist
  • Dyersburg, TN
National Provider Identifier
1619992450
Registry record updated Dec 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PT COMPANY
Practice address
1400 Shelby Dr
Dyersburg, TN 38024-3435
Phone
(731) 288-5056
Fax
(731) 288-5067
NPI assigned
Jul 13, 2006
Last updated
Dec 18, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Misty D Jackson
Title
Billing / Office Manager
Phone
(731) 288-5056

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

1400 Shelby Dr
Dyersburg, TN 38024-3435

Mailing address

1400 Shelby Dr
Dyersburg, TN 38024-3435
Phone (731) 288-5056

Other identifiers 2

IdentifierTypeStateIssuer
4039747OtherTNBCBS (GROUP)
0446661MedicaidTN

National Provider Directory

National Provider Directory

Locations

1723 Highway 51 S
Covington, TN 38019
Phone (901) 476-7666

1243 Highway 51 N
Ste 5
Ripley, TN 38063
Phone (731) 635-1055

787 Highway 51 N
Ste 1
Ripley, TN 38063
Phone (731) 635-1055

156 Davy Crockett Mall
Trenton, TN 38382
Phone (731) 855-0050

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387324800000",
    "number": "1619992450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 SHELBY DR",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "380243435",
            "telephone_number": "731-288-5056",
            "fax_number": "731-288-5067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 SHELBY DR",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "380243435",
            "telephone_number": "731-288-5056",
            "fax_number": "731-288-5067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PT COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2013-12-18",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "MISTY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "BILLING / OFFICE MANAGER",
        "authorized_official_telephone_number": "731-288-5056",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS (GROUP)",
            "identifier": "4039747",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0446661",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dyersburg, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2013; 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.