Individual provider Active NPI

Teresa T Duckworth, PT

  • Physical Therapist
  • Magee, MS
National Provider Identifier
1629418736
Registry record updated Apr 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT2015 Issued in MS
Practice address
805 3Rd St SW
Magee, MS 39111-3923
Phone
(601) 849-2734
Fax
(601) 849-2735
NPI assigned
Jul 3, 2013
Last updated
Apr 29, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2019

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 PT2015 MS Primary

Addresses

Primary practice location

805 3Rd St SW
Magee, MS 39111-3923

Mailing address

100 Pioneer Way
Magee, MS 39111-5501
Phone (601) 849-6440

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
PT2015MSMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
2083 Therapy, LLC Physical Therapist Current Accepting new patients

Locations

1151 Highway 35 S
Forest, MS 39074
Phone (601) 469-2732

100 Pioneer Way
Magee, MS 39111
Phone 6018496440245

357 Simpson Highway 149
Magee, MS 39111
Phone (601) 849-2734

805 3rd St SW
Magee, MS 39111
Phone (601) 849-2734

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1372809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556496000000",
    "number": "1629418736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PIONEER WAY",
            "city": "MAGEE",
            "state": "MS",
            "postal_code": "391115501",
            "telephone_number": "601-849-6440",
            "fax_number": "601-849-1332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 3RD ST SW",
            "city": "MAGEE",
            "state": "MS",
            "postal_code": "391113923",
            "telephone_number": "601-849-2734",
            "fax_number": "601-849-2735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUCKWORTH",
        "first_name": "TERESA",
        "middle_name": "T",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-03",
        "last_updated": "2019-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT2015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Magee, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2019; 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.