Mind. Body. Spirit. LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

MIND. BODY. SPIRIT. LLC

Practice address

114 Linda Dr
Vicksburg, MS 39180-8909

Phone

(601) 272-1756

Fax

(601) 272-1756

NPI assigned

Jul 29, 2021

Last updated

Sep 13, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Cortni Cooper, DPT

Title

Doctor of Physical Therapy

Phone

(601) 529-8829

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1627516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631491200000",
    "number": "1659044170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 LINDA DR",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391808909",
            "telephone_number": "601-272-1756",
            "fax_number": "601-272-1756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 LINDA DR",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391808909",
            "telephone_number": "601-272-1756",
            "fax_number": "601-272-1756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND. BODY. SPIRIT. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-29",
        "last_updated": "2021-09-13",
        "certification_date": "2021-09-13",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "CORTNI",
        "authorized_official_title_or_position": "DOCTOR OF PHYSICAL THERAPY",
        "authorized_official_telephone_number": "601-529-8829",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mississippi State Department of Health

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2021; 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.