Individual provider Active NPI

Amy Lynne Malone, MPT

  • Physical Therapist
  • Gulfport, MS
National Provider Identifier
1700923869
Registry record updated Apr 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT3406 Issued in MS
Practice address
11010 David St
Gulfport, MS 39503-3481
Phone
(228) 832-8327
Fax
(228) 832-8328
NPI assigned
Jan 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PTH3835 AL
Physical Therapist 225100000X PT3406 MS Primary

Addresses

Primary practice location

11010 David St
Gulfport, MS 39503-3481

Mailing address

PO Box 5776
Vancleave, MS 39565-5776
Phone (228) 826-1696

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120817000276 MS Practitioner - Physical Therapist in Private Practice 9133375579 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of South Alabama College of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Rehab of Greenville IncGroup PAC ID 8123014412, 5 clinicians

Practice addresses (Care Compare)

11010 David St
Gulfport, MS 39503-3481
Phone (228) 832-8327

4387 Leisure Time Dr
Diamondhead, MS 39525-3242
Phone (228) 255-3533

P O Box
Suite 7066
Gulfport, MS 39506-7066

Merit-based Incentive Payment System (MIPS)

Final score
20.93 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
69.75

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PTH3835ALMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Horrell Townsend, DO, PLLC PastSince Jul 1, 2012 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618790400000",
    "number": "1700923869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5776",
            "city": "VANCLEAVE",
            "state": "MS",
            "postal_code": "395655776",
            "telephone_number": "228-826-1696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11010 DAVID ST",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395033481",
            "telephone_number": "228-832-8327",
            "fax_number": "228-832-8328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALONE",
        "first_name": "AMY",
        "middle_name": "LYNNE",
        "name_prefix": "Mrs.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2021-04-19",
        "certification_date": "2021-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "PTH3835",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT3406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulfport, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 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.