Professional Physical Therapy, Inc.
Organization Active NPI Physical Therapist · Belzoni, MS
NPI 1720282247 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1720282247
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT1324 (MS)
- Legal business name
- PROFESSIONAL PHYSICAL THERAPY, INC.
- Practice address
- 401 N Hayden St
Belzoni, MS 39038-3639 - Phone
- (662) 247-4446
- Fax
- (662) 247-2772
- NPI assigned
- Jun 11, 2007
- Organization subpart
- No
Authorized official
- Name
- Dana Carter
- Title
- Office Manager
- Phone
- (662) 247-4446
Practitioners 7
-
Price H Hodges, R.P.T.
-
Bryant W. Lary, R.P.T.
-
Michael T. Nix, R.P.T.
-
John Huff Walker III, NBCOT
-
Lee L James, P.T.
-
Lori P. Smith, OTR/L
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040513000906 | MS | Part B Supplier - Clinic/Group Practice | 2466442389 |
Receives reassigned benefits from 3 practitioners Practice locations: Belzoni, MS |
National Provider Directory
Locations
401 N Hayden St
Belzoni, MS 39038
Phone (662) 247-4446
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | PT1324 | MS | Yes |
| Physical Therapist |
225100000X | PT3777 | MS |
Addresses
Primary practice location
401 N Hayden St
Belzoni, MS 39038-3639
Mailing address
401 N Hayden St
Belzoni, MS 39038-3639
Phone (662) 247-4446
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9016292 | Medicaid | MS |
Other providers in Belzoni, MS
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- Patients Choice Medical Center of Humphreys County, LLC
- Patients' Choice Medical Center of Humphreys County, LLC
- Professional Nutrition Services LLC
- Quality Healthcare Management, LLC
- RCG Mississippi, Inc.
- Restoration Children Facilities Inc
- Restoration CMHC Partial Hospitalization Program, Corp
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All providers in Belzoni, MS · Physical Therapist in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.