Medicomp, Inc

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

MEDICOMP, INC

Doing business as

Copiah Wellness & Rehab

Practice address

236 Caldwell Dr
Hazlehurst, MS 39083-2723

Phone

(601) 894-9004

Fax

(601) 894-3004

NPI assigned

Mar 5, 2015

Last updated

Mar 5, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Joseph S McNulty III

Title

Ceo

Phone

(601) 849-6440

Specialties & licenses 1

Addresses

Other names 1

• Copiah Wellness & Rehab Doing business as

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

{
    "created_epoch": "1425513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425513600000",
    "number": "1750774493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2015 HIGHPOINTE DRIVE",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390423169",
            "telephone_number": "888-976-2667",
            "fax_number": "601-824-8828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "236 CALDWELL DR",
            "city": "HAZLEHURST",
            "state": "MS",
            "postal_code": "390832723",
            "telephone_number": "601-894-9004",
            "fax_number": "601-894-3004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICOMP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-05",
        "last_updated": "2015-03-05",
        "status": "A",
        "authorized_official_last_name": "MCNULTY",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "601-849-6440",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Copiah Wellness & Rehab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lashisna McClendon, CMHT
• Glenda Neighbors McConnell, OT/L
• Fred J McDonnell, MD
• Preston McDonnell, M.D.
• Elizabeth McKinley, R.D., L.D., NSCA-CPT
• Jason Dean Miles, OTR/L
• Chandra M. Minor, D.M.D.
• Mississippi Eye Care of Hazlehurst
• Mississippi State Department of Health
• Ms Medical Supplies, Inc.

• Physical Therapist in Hazlehurst, MS
• Providers in Hazlehurst, MS by specialty
• Physical Therapist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.