Individual provider Active NPI

Jason Anthony Vinson, DPT

  • Physical Therapist
  • Tupelo, MS
National Provider Identifier
1801205596
Registry record updated Aug 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT5595 Issued in MS
Practice address
1743 Cliff Gookin Blvd
Tupelo, MS 38801-6723
Phone
(662) 680-5216
Fax
(662) 680-5217
NPI assigned
Aug 6, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT5595 MS Primary

Addresses

Primary practice location

1743 Cliff Gookin Blvd
Tupelo, MS 38801-6723

Mailing address

1743 Cliff Gookin Blvd
Tupelo, MS 38801-6723
Phone (662) 680-5216

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, AL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20141224000663 MS Practitioner - Physical Therapist in Private Practice 6406179407 Reassigns benefits to 2 organizations
I20151209000471 AL Practitioner - Physical Therapist in Private Practice 6406179407 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT5595MSMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Drayer Physical Therapy-Alabama, LLC Physical Therapist CurrentSince Jun 15, 2015 Accepting new patients
Dpti Elite Physical Therapy LLC Physical Therapist CurrentSince Aug 24, 2015 Accepting new patients
Drayer Physical Therapy Mississippi LLC Physical Therapist CurrentSince Jun 1, 2017 Accepting new patients
Drayer Physical Therapy Alabama LLC CurrentSince Jun 15, 2015 Accepting new patients
Dpti Elite Physical Therapy LLC Physical Therapist Current Accepting new patients
Drayer Physical Therapy-Alabama, LLC Physical Therapist Current Accepting new patients
Drayer Physical Therapy Mississippi LLC Physical Therapist Past Accepting new patients
Drayer Physical Therapy Institute LLC Physical Therapist Past Accepting new patients

Locations

2215 Decatur Hwy
Ste 125
Gardendale, AL 35071
Phone (205) 285-8790

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

2531 Rocky Ridge Rd
Ste 101
Vestavia, AL 35243
Phone (205) 453-9350

199 N Brookmoore Dr
Columbus, MS 39705
Phone (662) 798-0108

117 Bo Bo Dr
Crystal Springs, MS 39059
Phone (601) 892-6330

2319 Highway 145
Saltillo, MS 38866
Phone (662) 869-9980

513 Academy Rd
Starkville, MS 39759
Phone (662) 268-8013

1743 Cliff Gookin Blvd
Tupelo, MS 38801
Phone (662) 550-8221

8205 Presidents Dr
#2
Hummelstown, PA 17036
Phone (717) 803-2560

Organizations & group practices 8

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": "1407283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407283200000",
    "number": "1801205596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1743 CLIFF GOOKIN BLVD",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388016723",
            "telephone_number": "662-680-5216",
            "fax_number": "662-680-5217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1743 CLIFF GOOKIN BLVD",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388016723",
            "telephone_number": "662-680-5216",
            "fax_number": "662-680-5217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINSON",
        "first_name": "JASON",
        "middle_name": "ANTHONY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-06",
        "last_updated": "2014-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT5595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tupelo, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.