Brady J Church, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

6627 Issued in MS

Practice address

1707 W 20TH St
Laurel, MS 39440-1802

Phone

(601) 428-2004

Fax

(601) 428-8833

NPI assigned

Aug 16, 2011

Last updated

Dec 9, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Peak Physical Therapy LLCGroup PAC ID 2769997287, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Peak Physical Therapy, LLC

  dba Peak Physical Therapy

  • Physical Therapist
  • Laurel, MS
  • NPI 1437957446
  Medicare reassignment Care Compare group NPD Authorized official
• Gptrs II

  dba Genesis Physical Therapy and Rehabilitation Services LLC

  • Physical Therapist
  • Ridgeland, MS
  • NPI 1174851984
  NPD
• Genesis PT and Rehab Services

  • Physical Therapy Clinic/Center
  • Ridgeland, MS
  • NPI 1184768376
  NPD (past)

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

{
    "created_epoch": "1313452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765238400000",
    "number": "1881973329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1707 W 20TH ST",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394401802",
            "telephone_number": "601-428-2004",
            "fax_number": "601-428-8833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1707 W 20TH ST",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394401802",
            "telephone_number": "601-428-2004",
            "fax_number": "601-428-8833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHURCH",
        "first_name": "BRADY",
        "middle_name": "J",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-16",
        "last_updated": "2025-12-09",
        "certification_date": "2025-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "6627",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200006640",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chateau Transportation, LLC
• Rajvi Gajendra Chaudhary, M.D.
• Cheryl and Steve Inc. (Gibson Optical)
• Childrens Specialty Clinic of Laurel
• Edmund Chinchar
• Carlee Windham Church
• Jensen Ciacci, PA
• Amanda Clark
• William G. Clark, M.D.
• Rushie Clayton, LCSW

• Physical Therapist in Laurel, MS
• Providers in Laurel, MS by specialty
• Physical Therapist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2025; 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.