Pure Therapy, LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

PURE THERAPY, LLC

Doing business as

Pure Therapy, LLC

Practice address

7955 Huckleberry LN
Summit, MS 39666-7086

Phone

(601) 870-4360

NPI assigned

Sep 22, 2023

Last updated

Sep 27, 2023By 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

Micaela Temple Andrus, SLPNPI 1639958333

Title

Half Owner

Phone

(601) 870-4360

Specialties & licenses 1

Addresses

Other names 1

• Pure Therapy, LLC Doing business as

Medicare fee-for-service enrollment

Enrolled in MS, LA2 enrollments

Enrollment records 2

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Micaela Temple Andrus, SLP

  • Speech-Language Pathologist
  • Liberty, MS
  • NPI 1639958333

  LA

  Medicare reassignment NPD Authorized official
• Rebecca Claire Campbell, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Liberty, MS
  • NPI 1699622332
  NPD (past)
• Brittany Forman, CCC-SLP

  • Speech-Language Pathologist
  • Liberty, MS
  • NPI 1013811611

  Multi-Specialty

  NPD (past)

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

{
    "created_epoch": "1695340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695772800000",
    "number": "1669251369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7955 HUCKLEBERRY LN",
            "city": "SUMMIT",
            "state": "MS",
            "postal_code": "396667086",
            "telephone_number": "601-870-4360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7955 HUCKLEBERRY LN",
            "city": "SUMMIT",
            "state": "MS",
            "postal_code": "396667086",
            "telephone_number": "601-870-4360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PURE THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-22",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A",
        "authorized_official_last_name": "ANDRUS",
        "authorized_official_first_name": "MICAELA",
        "authorized_official_middle_name": "TEMPLE",
        "authorized_official_title_or_position": "HALF OWNER",
        "authorized_official_telephone_number": "601-870-4360",
        "authorized_official_credential": "SLP"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pure Therapy, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tanya K Powell, PTA, BS
• Alexandra Moore Price, DO
• Christopher Price, DMD
• Donald E Price, D.D.S.
• Staci M Price
• Shawana Ramsey Horne
• Jennifer Ray
• Michelle Ray
• Kellye Reeves
• Casey Rhodes

• Multi-Specialty Clinic/Center in Summit, MS
• Providers in Summit, MS by specialty
• Multi-Specialty Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2023; 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.