NPIMap

Organization Active NPI

Lighthouse Therapy LLC

  • Physical Therapist
  • Ocean Springs, MS
National Provider Identifier
1801367883
Registry record updated Jan 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 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
Last updated
Jan 31, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2023

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

Authorized official

Name
Mr. Vincent H. Cameron
Title
Chief Operations Officer
Phone
(228) 348-0694

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X Primary
Occupational TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225X00000X
Speech-Language PathologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1545004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675123200000",
    "number": "1801367883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5703 GULF TECH DR",
            "city": "OCEAN SPRINGS",
            "state": "MS",
            "postal_code": "395648238",
            "telephone_number": "228-875-5447",
            "fax_number": "228-875-5448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8905 OCEAN SPRINGS RD",
            "city": "OCEAN SPRINGS",
            "state": "MS",
            "postal_code": "395644419",
            "telephone_number": "228-875-5447",
            "fax_number": "228-875-5448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHTHOUSE THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-17",
        "last_updated": "2023-01-31",
        "certification_date": "2023-01-31",
        "status": "A",
        "authorized_official_last_name": "CAMERON",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "CHIEF OPERATIONS OFFICER",
        "authorized_official_telephone_number": "228-348-0694",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocean Springs, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2023; 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.