Dallis Glenn Forsythe, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT6663 Issued in MS

Practice address

5036 Goodman Rd Ste 110
Olive Branch, MS 38654-7966

Phone

(662) 586-2989

NPI assigned

Jun 3, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Drayer Physical Therapy Mississippi LLCGroup PAC ID 3274834858, 113 clinicians

Agilitas USA, IncGroup PAC ID 3375454648, 812 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Drayer Physical Therapy Mississippi LLC

  • Physical Therapist
  • Louisville, MS
  • NPI 1952732448
  Medicare reassignment Care Compare group NPD
• Agilitas USA Inc

  • Physical Therapy Clinic/Center
  • Hixson, TN
  • NPI 1962417444

  MS, Physical Therapist

  Medicare reassignment Care Compare group NPD
• Benchmark Physical Therapy of Mississippi LLC

  • Physical Therapist
  • Ocean Springs, MS
  • NPI 1811547680
  Medicare reassignment NPD
• Dpti Elite Physical Therapy LLC

  • Physical Therapist
  • Saltillo, MS
  • NPI 1386010718
  Medicare reassignment NPD
• Dpti Elite Physical Therapy LLC

  • Physical Therapist
  • Baldwyn, MS
  • NPI 1013383496
  NPD
• Agilitas USA, Inc

  • Physical Therapy Clinic/Center
  • Chattanooga, TN
  • NPI 1518695436

  Physical Therapist

  NPD
• Drayer Physical Therapy Mississippi LLC

  • Physical Therapist
  • Crystal Springs, MS
  • NPI 1801333521
  NPD (past)

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

{
    "created_epoch": "1559520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754524800000",
    "number": "1760040984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "423-238-7217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5036 GOODMAN RD STE 110",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386547966",
            "telephone_number": "662-586-2989"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "204 Enterprise Dr",
            "address_purpose": "LOCATION",
            "city": "Oxford",
            "state": "MS",
            "postal_code": "386552761",
            "country_code": "US",
            "telephone_number": "662-234-0010",
            "fax_number": "662-234-0017",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FORSYTHE",
        "first_name": "DALLIS",
        "middle_name": "GLENN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-03",
        "last_updated": "2025-08-07",
        "certification_date": "2025-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT6663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaylee Fisher, LMSW, LCSW
• Terrea Shenese Fleming
• Flemons Prosthetics
• Shelly L Flowers, FNP
• Manessha Teneal Floyd
• Michael E. Foster, M.D.
• Four Winds Counseling and Consulting
• Latrice Fox Dillard
• Charles H. Fraga, M.D.
• Galisa Franklin, CP

• Physical Therapist in Olive Branch, MS
• Providers in Olive Branch, MS by specialty
• Physical Therapist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2025; 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.