Physical Therapy Occupational Therapy Speech Therapy

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

PHYSICAL THERAPY OCCUPATIONAL THERAPY SPEECH THERAPY

Practice address

3419 Wisconsin Ave
Vicksburg, MS 39180-5330

Phone

(601) 629-0505

NPI assigned

Aug 5, 2024

Last updated

Dec 3, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Cortney Dearman

Title

Owner

Phone

(601) 480-8025

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Locations

Practitioners 1

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.

• Margaret Shrader, DPT

  • Geriatric Physical Therapist
  • Jackson, MS
  • NPI 1912377797

  Geriatrics

  Medicare reassignment NPD

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

{
    "created_epoch": "1722816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764720000000",
    "number": "1922838994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 POPPYSEED LN",
            "city": "RAYMOND",
            "state": "MS",
            "postal_code": "391542100",
            "telephone_number": "601-480-8025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3419 WISCONSIN AVE",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391805330",
            "telephone_number": "601-629-0505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL THERAPY OCCUPATIONAL THERAPY SPEECH THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-05",
        "last_updated": "2025-12-03",
        "certification_date": "2025-12-03",
        "status": "A",
        "authorized_official_last_name": "DEARMAN",
        "authorized_official_first_name": "CORTNEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-480-8025"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Claudia Ann Perrier, RPH
• Felecia Peters
• Beverly B Pettigrew
• Hein Phan, M.D.
• Danielle Phelps
• Physician Management Services of Mississippi, LLC
• Physician Practice of Madison, PC
• Physicians Sleep Diagnostics, Inc
• Paul W Pierce IV, M.D.
• Holland J Pitre, MD

• Physical Therapist in Vicksburg, MS
• Providers in Vicksburg, MS by specialty
• Physical Therapist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.