Fortinberry Physical Therapy LLC
Organization Active NPI Physical Therapist · Summit, MS
NPI 1891246286 · NPPES record last updated Dec 15, 2021
Key facts
- NPI
- 1891246286
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT2344 (MS)
- Legal business name
- FORTINBERRY PHYSICAL THERAPY LLC
- Practice address
- 709 Robb Street
Summit, MS 39666 - Phone
- (601) 248-8019
- NPI assigned
- Oct 20, 2016
- Organization subpart
- No
Authorized official
- Name
- Dr. Brad Fortinberry, DPT
- Title
- Owner
- Phone
- (601) 248-8019
Practitioners 7
-
Austin H Fortinberry, DPT
-
Brad Fortinberry, DPT
-
Joshua C Hutson, DPT
-
Kelly H Martin, DPT,ATC
-
Emily Troxler, DPT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170203002227 | MS | Part B Supplier - Physical/Occupational Therapy Group in Private Practice | 4981987658 |
Receives reassigned benefits from 7 practitioners Practice locations: Liberty, MS; Summit, MS; Tylertown, MS |
National Provider Directory
Locations
101 W Freedom Dr
Liberty, MS 39645
Phone (601) 276-2200
709 Robb St
#1358
Summit, MS 39666
Phone (601) 248-8019
709 Robb St
Summit, MS 39666
Phone (601) 248-8019
4916 Plaza Dr
Tylertown, MS 39667
Phone (601) 876-1234
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | PT2344 | MS | Yes |
Addresses
Primary practice location
709 Robb Street
Summit, MS 39666
Mailing address
PO Box 1358
Summit, MS 39666-1301
Phone (601) 276-2200
Other names
- Fortinberry Physical Therapy
Other providers in Summit, MS
- Embracing Hearts Healthcare
- Ruth Entremont
- Jonathan Faulkner
- Amanda Fischer
- Jamie Ford
- Austin H Fortinberry
- Brad Fortinberry
- Melissa Fortinberry
- Danny Francis Jr.
- Johnathan G Freeman
All providers in Summit, MS · Physical Therapist in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 15, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.