Individual provider Active NPI

Kaitlyn Harthcock, DPT

  • Physical Therapist
  • Carthage, MS
National Provider Identifier
1700454675
Registry record updated Jun 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
1018 Highway 16 E
Carthage, MS 39051-4220
Phone
(601) 267-3241
NPI assigned
Jun 16, 2021
Last updated
Jun 16, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 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 Primary

Addresses

Primary practice location

1018 Highway 16 E
Carthage, MS 39051-4220

Mailing address

921 W Beacon St
Philadelphia, MS 39350-3229

Other practice location 1

921 W Beacon St
Philadelphia, MS 39350-3229
Phone (601) 650-0002

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210729000348 MS Practitioner - Physical Therapist in Private Practice 0446653364 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Performance Therapy LLCGroup PAC ID 7012971047, 86 clinicians

Practice addresses (Care Compare)

1018 Hwy 16 E
Carthage, MS 39051-4220
Phone (601) 267-3241

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Performance Therapy LLC Physical Therapist CurrentSince Jun 7, 2021 Accepting new patients
Performance Therapy LLC PastSince Jun 7, 2021 Accepting new patients

Locations

1018 Highway 16 E
Carthage, MS 39051
Phone (601) 267-3241

3000 Old Canton Rd
Ste 110
Jackson, MS 39216
Phone (601) 982-7811

1058 Holland Ave
Philadelphia, MS 39350
Phone (601) 650-0002

921 W Beacon St
Philadelphia, MS 39350
Phone (601) 650-0002

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1623801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623801600000",
    "number": "1700454675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 W BEACON ST",
            "city": "PHILADELPHIA",
            "state": "MS",
            "postal_code": "393503229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1018 HIGHWAY 16 E",
            "city": "CARTHAGE",
            "state": "MS",
            "postal_code": "390514220",
            "telephone_number": "601-267-3241"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "921 W Beacon St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "MS",
            "postal_code": "393503229",
            "country_code": "US",
            "telephone_number": "601-650-0002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARTHCOCK",
        "first_name": "KAITLYN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-16",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carthage, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.