Individual provider Active NPI

Jessica Deffes Huckaby, PT

  • Physical Therapist
  • Columbus, MS
National Provider Identifier
1700815628
Registry record updated Mar 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT2336 Issued in MS
Practice address
2406 Highway 45 N
Suite a
Columbus, MS 39705-1398
Phone
(662) 329-9445
Fax
(662) 329-9462
NPI assigned
Jul 2, 2006
Last updated
Mar 2, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2011

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 PT2336 MS Primary

Addresses

Primary practice location

2406 Highway 45 N
Suite a
Columbus, MS 39705-1398

Mailing address

PO Box 8419
Biloxi, MS 39535-8087
Phone (228) 388-5714

Other identifiers 2

IdentifierTypeStateIssuer
1033218524OtherMSGROUP NPI
09015077MedicaidMS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040405000120 MS Practitioner - Physical Therapist in Private Practice 4385637669 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Mississippi School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Encore Rehabilitation, IncGroup PAC ID 3577462126, 182 clinicians

Practice addresses (Care Compare)

2406 Hwy 45 N a
Columbus, MS 39705-1398
Phone (662) 329-9445

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT2336MSMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Encore Rehabilitation, Inc. Physical Therapist CurrentSince Jun 26, 2017 Accepting new patients
Encore Rehabilitation, Inc. Physical Therapist CurrentSince Jun 26, 2017 Accepting new patients
Encore Rehabilitation Inc Past Accepting new patients
Encore Rehabilitation Inc Physical Therapist Past Accepting new patients
Encore Rehabilitation Inc Physical Therapist Past Accepting new patients
Encore Rehabilitation Inc Physical Therapist Past Accepting new patients
Encore Rehabilitation Inc Physical Therapist Past Accepting new patients
Encore Rehabilitation Inc Physical Therapist Past Accepting new patients
Encore Rehabilitation Inc Physical Therapist Past Accepting new patients
Encore Rehabiliation Inc Physical Therapist Past Accepting new patients
Encore Rehabilitation Inc Physical Therapist Past Accepting new patients
Encore Rehabilitation Inc Past Accepting new patients
Encore Rehabilitation Inc Physical Therapist Past Accepting new patients
Encore Rehabilitation Inc Physical Therapist Past Accepting new patients
Encore Rehabilitation Inc Physical Therapist Past Accepting new patients
Encore Rehabilitation Inc Past Accepting new patients

Locations

251 Johnston St SE
Ste 300
Decatur, AL 35601
Phone (256) 340-9708

2406 Highway 45 N
#A
Columbus, MS 39705

2406 Highway 45 N
Ste A
Columbus, MS 39705
Phone (662) 329-9445

433 Main St
Leakesville, MS 39451
Phone (601) 394-4545

Organizations & group practices 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299024000000",
    "number": "1700815628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8419",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395358087",
            "telephone_number": "228-388-5714",
            "fax_number": "228-388-0017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2406 HIGHWAY 45 N",
            "address_2": "SUITE A",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "397051398",
            "telephone_number": "662-329-9445",
            "fax_number": "662-329-9462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUCKABY",
        "first_name": "JESSICA",
        "middle_name": "DEFFES",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-02",
        "last_updated": "2011-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT2336",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1033218524",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09015077",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2011; 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.