Lighthouse Therapy LLC
Organization Active NPI Physical Therapist · Ocean Springs, MS
NPI 1801367883 · NPPES record last updated Jan 31, 2023
Key facts
- NPI
- 1801367883
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapist 225100000X
- Legal business name
- LIGHTHOUSE THERAPY LLC
- Practice address
- 8905 Ocean Springs Rd
Ocean Springs, MS 39564-4419 - Phone
- (228) 875-5447
- Fax
- (228) 875-5448
- NPI assigned
- Dec 17, 2018
- Organization subpart
- No
Authorized official
- Name
- Mr. Vincent H. Cameron
- Title
- Chief Operations Officer
- Phone
- (228) 348-0694
Practitioners 19
-
Jena Ball, PT
-
Baleigh N Booker, DPT
-
Carley Knochel, ST
-
Amber Sullivan, SLP
-
Natalie B Yurkow, MS CCC-SLP
-
Hannah M Strange, OT
-
Kristen Garner, OTR
-
Candice M. Davis, DPT, ATC
-
Savannah Lawler Allen, OTR/L
-
Shannon Jesiolowski, SLP
-
Michele J. Velez, SLP
-
Jennifer Sparks, PT
-
Darrell Glenn Finlay, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190429002824 | MS | Part B Supplier - Physical/Occupational Therapy Group in Private Practice | 8022350727 |
Receives reassigned benefits from 16 practitioners Practice locations: Ocean Springs, MS; Meridian, MS; Flowood, MS |
National Provider Directory
Locations
8520 S 36th Ter
Fort Smith, AR 72908
Phone (479) 410-1740
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | Yes | ||
| Occupational Therapist |
225X00000X | |||
| Speech-Language Pathologist |
235Z00000X |
Addresses
Primary practice location
8905 Ocean Springs Rd
Ocean Springs, MS 39564-4419
Mailing address
5703 Gulf Tech Dr
Ocean Springs, MS 39564-8238
Phone (228) 875-5447
Other providers in Ocean Springs, MS
- Gabrielle Andrea Lewis-Thomas
- Donna Maria Lewis
- Patricia Lewis
- Marshea Liddell
- Lifespan Wellness LLC
- Living Grace LLC
- LKM Resources LLC
- Sarah Crews Sparks Lochren
- Megan Elaine Lockley
- Michael Jay Loebenberg
All providers in Ocean Springs, 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 Jan 31, 2023. 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.