Abc Pediatric Therapy of Mississippi, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

ABC PEDIATRIC THERAPY OF MISSISSIPPI, LLC

Practice address

1130 Stateline Rd E Ste D-E
Southaven, MS 38671-8700

Phone

(662) 536-6884

Fax

(662) 510-5892

NPI assigned

Jul 24, 2023

Last updated

Jan 30, 2024By 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

Jessica Whalum, OTD, OTR/L

Title

Occupational Therapist

Phone

(662) 536-6884

Specialties & licenses 3

Addresses

Locations

Practitioners 4

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.

• Jessica Catledge, OTR/L

  • Occupational Therapist
  • Southaven, MS
  • NPI 1780113860
  NPD
• Gabrielle Grace Davis, COTA/L

  • Occupational Therapy Assistant
  • Southaven, MS
  • NPI 1225885437
  NPD
• Marlee Hoing, COTA/L

  • Occupational Therapy Assistant
  • Southaven, MS
  • NPI 1174413603
  NPD (past)
• Terri Peace, OTR/L

  • Occupational Therapist
  • Southaven, MS
  • NPI 1669298006
  NPD (past)

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

{
    "created_epoch": "1690156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706572800000",
    "number": "1821778713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 STATELINE RD E STE D-E",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386718700",
            "telephone_number": "662-536-6884",
            "fax_number": "662-510-5892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 STATELINE RD E STE D-E",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386718700",
            "telephone_number": "662-536-6884",
            "fax_number": "662-510-5892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABC PEDIATRIC THERAPY OF MISSISSIPPI, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-24",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A",
        "authorized_official_last_name": "WHALUM",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "662-536-6884",
        "authorized_official_credential": "OTD, OTR/L"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• A & D Behavioral Solutions LLC
• A Mothers Love Home Care
• Abide Endodontics
• Andrew Elias Abide Jr., DMD
• John A Acosta, D.D.S.
• Kayla E Adair, OTR/L
• Tara Adams, P-LPC

• Physical Therapy Clinic/Center in Southaven, MS
• Providers in Southaven, MS by specialty
• Physical Therapy Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2024; 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.