Lillian Gibb, PT
Individual provider Active NPI Physical Therapist · Petal, MS
NPI 1962494229 · NPPES record last updated Nov 17, 2011
Key facts
- NPI
- 1962494229
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT3113 (MS)
- Practice address
- 1227 Hwy 42
Suite 110
Petal, MS 39465-2790 - Phone
- (601) 545-2728
- Fax
- (601) 545-2792
- NPI assigned
- Aug 22, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rehab at Work of South Mississippi | Physical Therapist | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT3113 | MS | Yes |
Addresses
Primary practice location
1227 Hwy 42
Suite 110
Petal, MS 39465-2790
Mailing address
1227 Hwy 42
Suite 110
Petal, MS 39465-2790
Phone (601) 545-2728
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 05924395 | Medicaid | MS |
Other providers in Petal, MS
- Sara E Foster
- G G Morrison LLC
- Shawnta Senice Gandy
- Lauren O'Neal Garner
- Allison Garrett
- Katie Beth Gibbs
- Gibsons Pharmacy No3
- George Gillespie III
- Ted Gene Harden II
- Charles J. Harrell Jr.
All providers in Petal, 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 Nov 17, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.