Good Samaritan Pediatrics Specialists

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

GOOD SAMARITAN PEDIATRICS SPECIALISTS

Practice address

4290 Lakeland Dr
Suite B
Flowood, MS 39232-9571

Phone

(601) 638-4076

Fax

(601) 638-4979

NPI assigned

Nov 9, 2006

Organization subpart

No

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

Authorized official

Name

Fermika Smith

Title

Business Manager

Phone

(601) 638-4076

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1669542353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 822394",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391822394",
            "telephone_number": "601-638-4076",
            "fax_number": "601-638-4979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4290 LAKELAND DR",
            "address_2": "SUITE B",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329571",
            "telephone_number": "601-638-4076",
            "fax_number": "601-638-4979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD SAMARITAN PEDIATRICS SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-09",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "FERMIKA",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "601-638-4076"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03675793",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sherry S Gleason
• Mary Christina Glick, M.D.
• Edward Charles Gnam III, M.D.
• Justin R. Goebel, PA
• Good Faith Wellness Center PLLC
• Good Shepard LLC
• Gregory Andrew Gordon, M.D.
• Kaleigh Christian Gordon, SLP-CCC
• Goree Psychiatric Services, LLC
• Anna Caroline Goss

• Physical Therapy Clinic/Center in Flowood, MS
• Providers in Flowood, MS by specialty
• Physical Therapy Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.