Individual provider Active NPI

Jessica Gail Martin, RPT

  • Physical Therapist
  • Forest, MS
National Provider Identifier
1629149406
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT3789 Issued in MS
Practice address
813 W Third St
Forest, MS 39074-4006
Phone
(601) 469-1001
Fax
(601) 469-1009
NPI assigned
Nov 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PT3789 MS Primary

Addresses

Primary practice location

813 W Third St
Forest, MS 39074-4006

Mailing address

PO Box 426
Magee, MS 39111-0426
Phone (601) 849-6440

Other identifiers 1

IdentifierTypeStateIssuer
06584588MedicaidMS

Other names 1

  • Jessica Gail Loflin Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT3789MSMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Medicomp Inc. Past Accepting new patients
Medicomp, Inc. Physical Therapist Past Accepting new patients

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": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629149406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 426",
            "city": "MAGEE",
            "state": "MS",
            "postal_code": "391110426",
            "telephone_number": "601-849-6440",
            "fax_number": "601-849-7557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "813 W THIRD ST",
            "city": "FOREST",
            "state": "MS",
            "postal_code": "390744006",
            "telephone_number": "601-469-1001",
            "fax_number": "601-469-1009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JESSICA",
        "middle_name": "GAIL",
        "credential": "RPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT3789",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06584588",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "LOFLIN",
            "middle_name": "GAIL",
            "credential": "RPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Forest, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.