Calvin L. Braddock, PT
Individual provider Active NPI Physical Therapist · Starkville, MS
NPI 1679449185 · NPPES record last updated Oct 13, 2025
Key facts
- NPI
- 1679449185
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 1271 (MS)
- Practice address
- 74 Claiborne Way
Starkville, MS 39759-8544 - Phone
- (877) 407-3422
- Fax
- (877) 407-4329
- NPI assigned
- Oct 13, 2025
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Fox Rehab Agency Ms LLC
Practice addresses (Care Compare)
Starkville, MS 39759
Phone (877) 407-3422
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251105000675 | MS | Practitioner - Physical Therapist in Private Practice | 4284124694 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1271 | MS | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fox Rehab Agency Ms LLC | Physical Therapist | Current |
Accepting new patients |
Locations
74 Claiborne Way
Starkville, MS 39759
Phone (662) 268-9555
7 Carnegie Plz
Cherry Hill, NJ 08003
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1271 | MS | Yes |
Addresses
Primary practice location
74 Claiborne Way
Starkville, MS 39759-8544
Mailing address
7 Carnegie PLZ
Cherry Hill, NJ 08003-1000
Phone (877) 407-3422
Other providers in Starkville, MS
- Boa Vida Hospital of Aberdeen, Ms LLC
- Helen Brinkley Bohon
- Tamia Janae Bouldes
- Brittany Bowlin
- Alicia F Box
- Tamika R Bradford
- Brainfruit Counseling LLC
- Marlee Conn Brandon
- Steven Carmichael Brandon
- Sarah Dayton Gamble Brasfield
All providers in Starkville, MS · Physical Therapist in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 13, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.