Organization Active NPI

V a South

  • Physical Therapist
  • Jackson, MS
National Provider Identifier
1821152877
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT3192 Issued in MS
Legal business name
V A SOUTH
Practice address
4304 Highway 80 W Ste a
Jackson, MS 39209-5922
Phone
(601) 636-6019
Fax
(601) 661-8457
NPI assigned
Dec 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Mr. Marcus T Harris, PT
Title
Owner
Phone
(601) 927-7671

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X PT3192 MS Primary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X OT2019 MS

Addresses

Primary practice location

4304 Highway 80 W Ste a
Jackson, MS 39209-5922

Mailing address

PO Box 3183
Ridgeland, MS 39158-3183
Phone (601) 636-6019

Other identifiers 1

IdentifierTypeStateIssuer
00124552MedicaidMS

Other names 1

  • V A SOUTH Doing business as

National Provider Directory

National Provider Directory

Locations

4304 Highway 80 W
#A
Jackson, MS 39209
Phone (601) 983-6063

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1821152877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3183",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391583183",
            "telephone_number": "601-636-6019",
            "fax_number": "601-661-8457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4304 HIGHWAY 80 W STE A",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392095922",
            "telephone_number": "601-636-6019",
            "fax_number": "601-661-8457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "V A SOUTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-21",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "MARCUS",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-927-7671",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT3192",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "MS",
            "license": "OT2019",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00124552",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "V A SOUTH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.