Individual provider Active NPI

Lauren Elizabeth Roberts, DPT

  • Physical Therapist
  • Flowood, MS
National Provider Identifier
1639645401
Registry record updated Aug 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT5267 Issued in MS
Practice address
1050 N Flowood Dr
Flowood, MS 39232-9738
Phone
(601) 345-4180
Fax
(601) 345-4790
NPI assigned
Oct 19, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 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 PT5267 MS Primary

Addresses

Primary practice location

1050 N Flowood Dr
Flowood, MS 39232-9738

Mailing address

108 Hawthorne Vale
Ridgeland, MS 39157-2352

Other practice location 1

1220 N Shore Pkwy Ste B
Brandon, MS 39047-6383
Phone (601) 829-0505

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191007002581 MS Practitioner - Physical Therapist in Private Practice 2668703539 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Drayer Physical Therapy Mississippi LLCGroup PAC ID 3274834858, 113 clinicians

Practice addresses (Care Compare)

111 Dees Dr
Suite D
Gluckstadt, MS 39110-5065
Phone (769) 225-2165

117 Bo Bo Dr
Crystal Springs, MS 39059-2741
Phone (601) 892-6330

7213 S Siwell Rd
Suite a
Byram, MS 39272-9776
Phone (601) 346-9191

772 Lake Harbour Dr
Suite 3
Ridgeland, MS 39157-4365
Phone (601) 899-0002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Drayer Physical Therapy Mississippi LLC Physical Therapist CurrentSince Sep 4, 2019 Accepting new patients
5 Star Performance Center, LLC Physical Therapist CurrentSince Sep 8, 2021 Accepting new patients
Drayer Physical Therapy Mississippi LLC Physical Therapist Past Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

1220 N Shore Pkwy
#B
Brandon, MS 39047
Phone (601) 829-0505

199 N Brookmoore Dr
Columbus, MS 39705
Phone (662) 798-0108

117 Bo Bo Dr
Crystal Springs, MS 39059
Phone (601) 892-6330

4500 Lakeland Dr
Flowood, MS 39232
Phone (769) 251-1166

Organizations & group practices 3

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": "1539907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567036800000",
    "number": "1639645401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 HAWTHORNE VALE",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391572352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 N FLOWOOD DR",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329738",
            "telephone_number": "601-345-4180",
            "fax_number": "601-345-4790"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1220 N Shore Pkwy Ste B",
            "address_purpose": "LOCATION",
            "city": "Brandon",
            "state": "MS",
            "postal_code": "390476383",
            "country_code": "US",
            "telephone_number": "601-829-0505",
            "fax_number": "601-829-0506",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "LAUREN",
        "middle_name": "ELIZABETH",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-19",
        "last_updated": "2019-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT5267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flowood, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.