Larina Smith Mason, PT
Individual provider Active NPI Physical Therapist · Vicksburg, MS
NPI 1629320643 · NPPES record last updated Oct 15, 2012
Key facts
- NPI
- 1629320643
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT 3041 (MS)
- Practice address
- 2222 S Frontage Rd
Suite D
Vicksburg, MS 39180-5271 - Phone
- (601) 456-0159
- NPI assigned
- Oct 15, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Scott Robbins Physical Therapy, PC
Practice addresses (Care Compare)
2222 S Frontage Rd
Suite D
Vicksburg, MS 39180-5271
2222 S Frontage Rd D
Vicksburg, MS 39180-5271
Phone (601) 456-0159
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130710000019 | MS | Practitioner - Physical Therapist in Private Practice | 8820238199 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT 3041 | MS | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Scott Robbins Physical Therapy, PC | Current |
Accepting new patients | |
| Performance Therapy LLC | Physical Therapist | Current |
Accepting new patients |
Locations
1301 W Government St
Ste 104
Brandon, MS 39042
Phone (601) 591-7535
921 W Beacon St
Philadelphia, MS 39350
Phone (601) 650-0002
1058 Holland Ave
Philadelphia, MS 39350
Phone (601) 650-0002
2222 S Frontage Rd
Ste D
Vicksburg, MS 39180
Phone (601) 456-0159
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT 3041 | MS | Yes |
Addresses
Primary practice location
2222 S Frontage Rd
Suite D
Vicksburg, MS 39180-5271
Mailing address
2116 N Chapel Hill Rd
Raymond, MS 39154-8064
Other providers in Vicksburg, MS
- Carey Martin
- Karen Martin
- Qualon L. Martin
- Margo Marveggio
- Mary Kelley Inc
- Robert C Masterson
- Jacenta Matthews
- Cindy Marie Lescallette McCarley
- Miranda R McCaskill
- Fawn McCleave Francis
All providers in Vicksburg, MS · Physical Therapist in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 15, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.