Individual provider Active NPI

Michael Wilcher, PT

  • Physical Therapist
  • Philadelphia, MS
National Provider Identifier
1922170240
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT4104 Issued in MS
Practice address
180 Canal PL
Philadelphia, MS 39350-8908
Phone
(601) 650-0002
Fax
(601) 650-9902
NPI assigned
Nov 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PT4104 MS Primary

Addresses

Primary practice location

180 Canal PL
Philadelphia, MS 39350-8908

Mailing address

7984 Ebenezer Rd
Carthage, MS 39051-7729
Phone (601) 416-3698

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070926000567 MS Practitioner - Physical Therapist in Private Practice 1850485483 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Performance Therapy LLCGroup PAC ID 7012971047, 86 clinicians

Practice addresses (Care Compare)

1018 Hwy 16 E
Carthage, MS 39051-4220
Phone (601) 267-3241

1058 Holland Ave
Philadelphia, MS 39350-9121
Phone (601) 650-0002

921 W Beacon St
Philadelphia, MS 39350-3229

921 W Beacon St
Philadelphia, MS 39350-8908
Phone (601) 650-0002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Performance Therapy LLC Physical Therapist CurrentSince Nov 15, 2006 Accepting new patients
Performance Therapy LLC Past Accepting new patients

Locations

1018 Highway 16 E
Carthage, MS 39051
Phone (601) 267-3241

180 Canal Pl
Philadelphia, MS 39350
Phone (601) 650-0002

921 W Beacon St
Philadelphia, MS 39350
Phone (601) 650-0002

1058 Holland Ave
Philadelphia, MS 39350
Phone (601) 650-0002

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922170240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7984 EBENEZER RD",
            "city": "CARTHAGE",
            "state": "MS",
            "postal_code": "390517729",
            "telephone_number": "601-416-3698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 CANAL PL",
            "city": "PHILADELPHIA",
            "state": "MS",
            "postal_code": "393508908",
            "telephone_number": "601-650-0002",
            "fax_number": "601-650-9902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILCHER",
        "first_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT4104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.