Individual provider Active NPI

Myles Darian Faries, OT

  • Occupational Therapist
  • Jackson, MS
National Provider Identifier
1861375313
Registry record updated Apr 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT-27008 Issued in FL
Practice address
1325 E Fortification St
Jackson, MS 39202-2442
Phone
(601) 354-4488
Fax
(601) 351-5980
NPI assigned
Jul 30, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT-27008 FL Primary

Addresses

Primary practice location

1325 E Fortification St
Jackson, MS 39202-2442

Mailing address

1325 E Fortification St
Jackson, MS 39202-2442
Phone (601) 354-4488

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250923004278 MS Practitioner - Occupational Therapist in Private Practice 2961907779 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1325 E Fortification St
Jackson, MS 39202-2442

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT-27008FLMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mississippi Sports Medicine & Orthopaedic Center CurrentSince Jul 30, 2025 Accepting new patients

Locations

1325 E Fortification St
Jackson, MS 39202
Phone (601) 354-4488

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1753833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775520000000",
    "number": "1861375313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 E FORTIFICATION ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022442",
            "telephone_number": "601-354-4488",
            "fax_number": "601-351-5980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 E FORTIFICATION ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022442",
            "telephone_number": "601-354-4488",
            "fax_number": "601-351-5980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARIES",
        "first_name": "MYLES",
        "middle_name": "DARIAN",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-07-30",
        "last_updated": "2026-04-07",
        "certification_date": "2026-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT-27008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Apr 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.