Individual provider Active NPI

Michael Busby, PT

  • Physical Therapist
  • Vicksburg, MS
National Provider Identifier
1881147247
Registry record updated May 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT5959 Issued in MS
Practice address
1901A Mission 66
Vicksburg, MS 39180-3711
Phone
(601) 638-5518
Fax
(601) 638-7122
NPI assigned
Aug 2, 2016
Last updated
May 18, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2026

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 PT5959 MS Primary

Addresses

Primary practice location

1901A Mission 66
Vicksburg, MS 39180-3711

Mailing address

PO Box 820039
Vicksburg, MS 39182-0039
Phone (601) 638-5518

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170616002154 MS Practitioner - Physical Therapist in Private Practice 5890078141 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Axis Physical Therapy LLCGroup PAC ID 3476022039, 3 clinicians

Practice addresses (Care Compare)

1901 A Mission
Suite 66
Vicksburg, MS 39180-3711
Phone (601) 638-7122

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Axis Physical Therapy LLC Physical Therapist Current Accepting new patients
Elite Performance and Rehab, LLC Physical Therapist CurrentSince Feb 1, 2017 Accepting new patients
Good Samaritan Physical Therapy,Inc. Past Accepting new patients
Diagnostic Testing Solutions Past Accepting new patients

Locations

2080 S Frontage Rd
Ste 108
Vicksburg, MS 39180
Phone (601) 629-4304

Organizations & group practices 4

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": "1470096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779062400000",
    "number": "1881147247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 820039",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391820039",
            "telephone_number": "601-638-5518",
            "fax_number": "601-638-7122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901A MISSION 66",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391803711",
            "telephone_number": "601-638-5518",
            "fax_number": "601-638-7122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSBY",
        "first_name": "MICHAEL",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-02",
        "last_updated": "2026-05-18",
        "certification_date": "2026-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT5959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vicksburg, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 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.