Individual provider Active NPI

Avery Sumrall

  • Physical Therapist
  • Gulfport, MS
National Provider Identifier
1649143637
Registry record updated Sep 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8083 Issued in MS
Practice address
1423 Magnolia St Apt D
Gulfport, MS 39507-3569
Phone
(228) 256-6015
NPI assigned
Sep 25, 2025
Last updated
Sep 25, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2025

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 8083 MS Primary

Addresses

Primary practice location

1423 Magnolia St Apt D
Gulfport, MS 39507-3569

Mailing address

1200 Corporate Dr Ste 400
Hoover, AL 35242-5424
Phone (423) 238-7217

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251013000486 MS Practitioner - Physical Therapist in Private Practice 9436646767 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
William Carey University College of Osteopathic Medicine, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1200 Corporate Dr
Suite 400
Hoover, AL 35242-2902

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dpti Elite Physical Therapy LLC Physical Therapist CurrentSince Sep 29, 2025 Accepting new patients
Dpti Elite Physical Therapy LLC Physical Therapist CurrentSince Sep 29, 2025 Accepting new patients
Agilitas USA, Inc Physical Therapist CurrentSince Sep 29, 2025 Accepting new patients
Benchmark Physical Therapy of Mississippi LLC Physical Therapist CurrentSince Sep 29, 2025 Accepting new patients
Drayer Physical Therapy Mississippi LLC Physical Therapist CurrentSince Sep 29, 2025 Accepting new patients
Agilitas USA Inc Physical Therapist CurrentSince Sep 29, 2025 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

921 Cedar Lake Rd
Ste O
Biloxi, MS 39532
Phone (228) 533-2545

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

4010 Bienville Blvd
Unit E
Ocean Springs, MS 39564
Phone (228) 300-6001

2319 Highway 145
Saltillo, MS 38866
Phone (662) 869-9980

3451 Goodman Rd E
Ste 108
Southaven, MS 38672
Phone (662) 253-9060

Organizations & group practices 7

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": "1758758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758758400000",
    "number": "1649143637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "423-238-7217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1423 MAGNOLIA ST APT D",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395073569",
            "telephone_number": "228-256-6015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMRALL",
        "first_name": "AVERY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-25",
        "last_updated": "2025-09-25",
        "certification_date": "2025-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "8083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulfport, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2025; 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.