NPIMap

Organization Active NPI

Genesis Physical Therapy

  • Physical Therapist
  • Jackson, MS
National Provider Identifier
1912001579
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
GENESIS PHYSICAL THERAPY
Practice address
1777 Ellis Ave
Suite B
Jackson, MS 39204-3616
Phone
(601) 372-1499
Fax
(601) 372-9862
NPI assigned
Sep 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Chassiety Grant
Title
Clinic Admin
Phone
(601) 372-1499

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

1777 Ellis Ave
Suite B
Jackson, MS 39204-3616

Mailing address

1777 Ellis Ave
Suite B
Jackson, MS 39204-3616
Phone (601) 372-1499

National Provider Directory

National Provider Directory
Tax ID family
Genesis PT and Rehab Services4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1912001579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1777 ELLIS AVE",
            "address_2": "SUITE B",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392043616",
            "telephone_number": "601-372-1499",
            "fax_number": "601-372-9862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1777 ELLIS AVE",
            "address_2": "SUITE B",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392043616",
            "telephone_number": "601-372-1499",
            "fax_number": "601-372-9862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GRANT",
        "authorized_official_first_name": "CHASSIETY",
        "authorized_official_title_or_position": "CLINIC ADMIN",
        "authorized_official_telephone_number": "601-372-1499"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.