Biogenics, LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

PT3612 Issued in MS

Legal business name

BIOGENICS, LLC

Practice address

307 Chartrese Dr
Brandon, MS 39047-8779

Phone

(601) 906-3718

NPI assigned

May 19, 2015

Last updated

May 19, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Scott Wayne Grantham, MPT

Title

Owner/Physical Therapist

Phone

(601) 906-3718

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Scotty W. Grantham, R.P.T.

  • Physical Therapist
  • Jackson, MS
  • NPI 1366524464
  NPD (past)

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

{
    "created_epoch": "1431993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431993600000",
    "number": "1821477167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 CHARTRESE DR",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390478779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 CHARTRESE DR",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390478779",
            "telephone_number": "601-906-3718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIOGENICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-19",
        "last_updated": "2015-05-19",
        "status": "A",
        "authorized_official_last_name": "GRANTHAM",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "601-906-3718",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MPT"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MS",
            "license": "PT3612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Bieski, CCC-SLP
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• Deanna Bishop, PMHNP-BC, LPC
• Ryan Black
• Charla Geri Blackwell
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• Noralyn Christina Blalock-Perkins, F.N.P.

• Clinic/Center in Brandon, MS
• Providers in Brandon, MS by specialty
• Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2015; 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.