NPIMap

Organization Active NPI

Madison Healthplex & Sports Performance Center LLC

  • Physical Therapist
  • Madison, MS
National Provider Identifier
1891117420
Registry record updated Feb 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
MADISON HEALTHPLEX & SPORTS PERFORMANCE CENTER LLC
Practice address
501 Baptist Dr
Madison, MS 39110-2026
Phone
(601) 944-1717
Fax
(601) 944-9780
NPI assigned
Jan 16, 2014
Last updated
Feb 27, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2014

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

Authorized official

Name
Amy Grissett
Title
Director of Operations
Phone
60194417172

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

501 Baptist Dr
Madison, MS 39110-2026

Mailing address

501 Baptist Dr
Madison, MS 39110-2026
Phone (601) 944-1717

National Provider Directory

National Provider Directory
Tax ID family
Madison Healthplex and Sports Performanc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1389830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393459200000",
    "number": "1891117420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 BAPTIST DR",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391102026",
            "telephone_number": "601-944-1717",
            "fax_number": "601-944-9780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 BAPTIST DR",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391102026",
            "telephone_number": "601-944-1717",
            "fax_number": "601-944-9780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADISON HEALTHPLEX & SPORTS PERFORMANCE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-16",
        "last_updated": "2014-02-27",
        "status": "A",
        "authorized_official_last_name": "GRISSETT",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "60194417172"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2014; 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.