NPIMap

Individual provider Active NPI

Mandy Williams Smith, PT

  • Physical Therapist
  • Poplarville, MS
National Provider Identifier
1891915922
Registry record updated Nov 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT4141 Issued in MS
Practice address
411 W North St
Poplarville, MS 39470-2203
Phone
(601) 795-2130
Fax
(601) 795-2164
NPI assigned
Apr 30, 2007
Last updated
Nov 21, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2008

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 PT4141 MS Primary

Addresses

Primary practice location

411 W North St
Poplarville, MS 39470-2203

Mailing address

PO Box 8419
Biloxi, MS 39535-8087
Phone (228) 388-5714

Other identifiers 2

IdentifierTypeStateIssuer
090-15077MedicaidMS
1033218524OtherMSGROUP NPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT4141MSMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Encore Rehabilitation Inc Past Accepting new patients
Encore Rehabilitation Inc Physical Therapist Past Accepting new patients
Encore Rehabilitation Inc Physical Therapist Past Accepting new patients
Encore Rehabilitation Inc Physical Therapist Past Accepting new patients
Encore Rehabilitation Inc Physical Therapist Past Accepting new patients
Encore Rehabilitation Inc Physical Therapist Past Accepting new patients
Encore Rehabilitation Inc Physical Therapist Past Accepting new patients
Encore Rehabiliation Inc Physical Therapist Past Accepting new patients
Encore Rehabilitation Inc Physical Therapist Past Accepting new patients
Encore Rehabilitation Inc Past Accepting new patients
Encore Rehabilitation Inc Physical Therapist Past Accepting new patients
Encore Rehabilitation Inc Physical Therapist Past Accepting new patients
Physiotherapy Associates Inc Past Accepting new patients
Ms Medical Supplies, Inc. Past Accepting new patients
Encore Rehabilitation Inc Physical Therapist Past Accepting new patients
Encore Rehabilitation Inc Past Accepting new patients

Organizations & group practices 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1177891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227225600000",
    "number": "1891915922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8419",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395358087",
            "telephone_number": "228-388-5714",
            "fax_number": "228-388-0017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 W NORTH ST",
            "city": "POPLARVILLE",
            "state": "MS",
            "postal_code": "394702203",
            "telephone_number": "601-795-2130",
            "fax_number": "601-795-2164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MANDY",
        "middle_name": "WILLIAMS",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-30",
        "last_updated": "2008-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT4141",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "090-15077",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1033218524",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Poplarville, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2008; 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.