Individual provider Active NPI

Kyle Avery Blount, DPT

  • Physical Therapist
  • Senatobia, MS
National Provider Identifier
1871072157
Registry record updated Jan 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT6540 Issued in MS
Practice address
105B Quality LN
Senatobia, MS 38668-2317
Phone
(662) 562-9977
Fax
(662) 562-9978
NPI assigned
Aug 8, 2018
Last updated
Jan 24, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT6540 MS Primary

Addresses

Primary practice location

105B Quality LN
Senatobia, MS 38668-2317

Mailing address

2714 W Oxford Loop
Ste 164
Oxford, MS 38655-5714
Phone (662) 327-6705

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180824000427 MS Practitioner - Physical Therapist in Private Practice 9537418512 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athletico LTDGroup PAC ID 4789602681, 2,187 clinicians

Practice addresses (Care Compare)

105 A Quality LN
Senatobia, MS 38668-2317
Phone (662) 562-9977

Merit-based Incentive Payment System (MIPS)

Final score
86.32 of 100Reported as group
Quality
84.44
Promoting interoperability
99
Improvement activities
40
Cost
70.78

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT6540MSMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Dpti Elite Physical Therapy LLC Physical Therapist CurrentSince Aug 6, 2018 Accepting new patients
Athletico LTD Physical Therapist CurrentSince Nov 15, 2021 Accepting new patients
Dpti Elite Physical Therapy LLC Physical Therapist CurrentSince Aug 6, 2018 Accepting new patients
Athletico LTD Physical Therapist CurrentSince Nov 15, 2021 Accepting new patients
Drayer Physical Therapy Mississippi LLC Physical Therapist CurrentSince Aug 3, 2018 Accepting new patients
Drayer Physical Therapy Mississippi LLC Physical Therapist PastSince Aug 3, 2018 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

199 N Brookmoore Dr
Columbus, MS 39705
Phone (662) 798-0108

117 Bo Bo Dr
Crystal Springs, MS 39059
Phone (601) 892-6330

2714 West Oxford Loop
Ste 164
Oxford, MS 38655
Phone (662) 232-8949

2319 Highway 145
Saltillo, MS 38866
Phone (662) 869-9980

105B Quality Ln
Senatobia, MS 38668
Phone (662) 562-9977

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1533686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579824000000",
    "number": "1871072157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2714 W OXFORD LOOP",
            "address_2": "STE 164",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386555714",
            "telephone_number": "662-327-6705",
            "fax_number": "662-327-6760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105B QUALITY LN",
            "city": "SENATOBIA",
            "state": "MS",
            "postal_code": "386682317",
            "telephone_number": "662-562-9977",
            "fax_number": "662-562-9978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOUNT",
        "first_name": "KYLE",
        "middle_name": "AVERY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-08",
        "last_updated": "2020-01-24",
        "certification_date": "2020-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT6540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Senatobia, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2020; 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.