NPIMap

Organization Active NPI

5 Star Performance Center, LLC

  • Physical Therapy Clinic/Center
  • Flowood, MS
National Provider Identifier
1689150054
Registry record updated Jul 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
5 STAR PERFORMANCE CENTER, LLC
Practice address
4500 Lakeland Dr
Flowood, MS 39232-9583
Phone
(601) 354-4488
NPI assigned
Jul 18, 2018
Last updated
Jul 18, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2018

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

Authorized official

Name
Glen Silverman
Title
Ceo
Phone
(601) 354-4488

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

4500 Lakeland Dr
Flowood, MS 39232-9583

Mailing address

4500 Lakeland Dr
Flowood, MS 39232-9583

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20181005000948 MS Part B Supplier - Physical/Occupational Therapy Group in Private Practice 3577815372 Receives reassigned benefits from 11 practitioners
Practice locations: Flowood, MS
O20250613001161 MS DME Supplier - Independently-Practicing Physical Therapist 3577815372 Practice locations: Flowood, MS

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

4500 Lakeland Dr
Flowood, MS 39232
Phone (769) 251-1166

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1531872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531872000000",
    "number": "1689150054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 LAKELAND DR",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 LAKELAND DR",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329583",
            "telephone_number": "601-354-4488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "5 STAR PERFORMANCE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-18",
        "last_updated": "2018-07-18",
        "status": "A",
        "authorized_official_last_name": "SILVERMAN",
        "authorized_official_first_name": "GLEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "601-354-4488"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flowood, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2018; 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.