NPIMap

Organization Active NPI

Genesis Physical Therapy

  • Physical Therapist
  • Laurel, MS
National Provider Identifier
1790800894
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT0780 Issued in MS
Legal business name
GENESIS PHYSICAL THERAPY
Practice address
1707 West 20TH Street
Laurel, MS 39442
Phone
(601) 428-2004
Fax
(601) 428-8833
NPI assigned
Mar 20, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Christy Holifield
Title
Office Manager
Phone
(601) 428-2004

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT0780 MS Primary

Addresses

Primary practice location

1707 West 20TH Street
Laurel, MS 39442

Mailing address

1707 West 20TH Street
Laurel, MS 39442
Phone (601) 428-2004

National Provider Directory

National Provider Directory
Tax ID family
Genesis Physical Therapy Rehabilitation Services4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790800894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1707 WEST 20TH STREET",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "39442",
            "telephone_number": "601-428-2004",
            "fax_number": "601-428-8833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1707 WEST 20TH STREET",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "39442",
            "telephone_number": "601-428-2004",
            "fax_number": "601-428-8833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HOLIFIELD",
        "authorized_official_first_name": "CHRISTY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "601-428-2004"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT0780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.