Individual provider Active NPI

Taylor M Johnson, DPT

  • Physical Therapist
  • Tupelo, MS
National Provider Identifier
1700431004
Registry record updated Jun 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT6729 Issued in MS
Practice address
1211 S Gloster St Ste C
Tupelo, MS 38801-6548
Phone
(662) 432-1523
Fax
(662) 432-1528
NPI assigned
Aug 5, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT6729 MS Primary

Addresses

Primary practice location

1211 S Gloster St Ste C
Tupelo, MS 38801-6548

Mailing address

8205 Presidents Dr
Hummelstown, PA 17036-8621
Phone (717) 839-2188

Other practice location 1

65 Dutch Ln
Columbus, MS 39702-5523
Phone (662) 241-4545

Other names 1

  • Taylor M Brown Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190826000704 MS Practitioner - Physical Therapist in Private Practice 5496083727 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Drayer Physical Therapy Mississippi LLCGroup PAC ID 3274834858, 113 clinicians

Practice addresses (Care Compare)

117 Bo Bo Dr
Crystal Springs, MS 39059-2741
Phone (601) 892-6330

199 N Brookmoore Dr
Columbus, MS 39705-2024
Phone (662) 328-4542

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT6729MSMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Dpti Elite Physical Therapy LLC Physical Therapist CurrentSince Aug 5, 2019 Accepting new patients
Drayer Physical Therapy Mississippi LLC Physical Therapist CurrentSince Aug 5, 2019 Accepting new patients
Dpti Elite Physical Therapy LLC Physical Therapist CurrentSince Aug 5, 2019 Accepting new patients
Specialty Orthopedic Group of Mississippi PLLC PastSince Aug 5, 2019 Accepting new patients
Drayer Physical Therapy Mississippi LLC Physical Therapist Past Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

65 Dutch Ln
Columbus, MS 39702
Phone (662) 241-4545

199 N Brookmoore Dr
Columbus, MS 39705
Phone (662) 798-0108

117 Bo Bo Dr
Crystal Springs, MS 39059
Phone (601) 892-6330

2319 Highway 145
Saltillo, MS 38866
Phone (662) 869-9980

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1564963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623628800000",
    "number": "1700431004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8205 PRESIDENTS DR",
            "city": "HUMMELSTOWN",
            "state": "PA",
            "postal_code": "170368621",
            "telephone_number": "717-839-2188",
            "fax_number": "717-565-1104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 S GLOSTER ST STE C",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388016548",
            "telephone_number": "662-432-1523",
            "fax_number": "662-432-1528"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "65 Dutch Ln",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "MS",
            "postal_code": "397025523",
            "country_code": "US",
            "telephone_number": "662-241-4545",
            "fax_number": "662-241-4025",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TAYLOR",
        "middle_name": "M",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-05",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT6729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAYLOR",
            "last_name": "BROWN",
            "middle_name": "M",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tupelo, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.