Pro PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

PRO PT

Practice address

3077 Highway 371 N
Mantachie, MS 38855-7274

Phone

(662) 282-4949

Fax

(662) 282-4955

NPI assigned

Mar 15, 2012

Organization subpart

No

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

Authorized official

Name

Cory Lee, LPTA

Title

Owner

Phone

(662) 231-0280

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Pro Therapy Doing business as

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Alisha Gholston Comer, MS,CCC-SLP

  • Speech-Language Pathologist
  • Olive Branch, MS
  • NPI 1700807690
  Medicare reassignment Care Compare group NPD
• Michael Anthony McBryde, PT, DPT

  • Physical Therapist
  • Nettleton, MS
  • NPI 1467930537
  Medicare reassignment Care Compare group NPD
• Katie Leigh Reeves, PT, DPT

  • Physical Therapist
  • Ridgeland, MS
  • NPI 1699213462
  Medicare reassignment NPD
• Virginia M Sprayberry, SLP

  • Speech-Language Pathologist
  • Mantachie, MS
  • NPI 1194203505
  NPD (past)
• Raquel Ziegler, PT, DPT

  • Physical Therapist
  • Nettleton, MS
  • NPI 1952813677
  NPD (past)
• Brett Kellett Allan Jr., DC

  • Chiropractor
  • San Diego, CA
  • NPI 1487738563
  NPD (past)

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

{
    "created_epoch": "1331769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466985600000",
    "number": "1629343124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 205",
            "city": "MANTACHIE",
            "state": "MS",
            "postal_code": "388550205",
            "telephone_number": "662-282-4949",
            "fax_number": "662-282-4955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3077 HIGHWAY 371 N",
            "city": "MANTACHIE",
            "state": "MS",
            "postal_code": "388557274",
            "telephone_number": "662-282-4949",
            "fax_number": "662-282-4955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO PT",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-15",
        "last_updated": "2016-06-27",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "CORY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "662-231-0280",
        "authorized_official_credential": "LPTA"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08130311",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pro Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mantachie Rural Health Care, Inc
• Mantachie Rural Health Care, Inc. Dental
• Susan Long Newell
• Crystal Jo Nichols, C.F.N.P.
• Trinity K Nichols, PHARMD
• Cynthia Smith, FNP
• Johnathon Crawford Smith Sr., CLPN
• Kristi Diann Smith, MSN, FNP-C
• Katlyn Spradling
• Virginia M Sprayberry, SLP

• Physical Therapist in Mantachie, MS
• Providers in Mantachie, MS by specialty
• Physical Therapist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.