Active NPI
Travis Castleberry, P.T.
- Physical Therapist
- Nettleton, MS
National Provider Identifier
1962816447
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT6113
- Practice address
- 230A Main Street
Nettleton, MS 38855 - Phone
- (662) 591-7077
- Fax
- (662) 591-7078
- NPI assigned
- Jun 12, 2014
- Last updated
- Apr 12, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 9998 | TN | |
| Physical Therapist | 225100000X | PT6113 | MS | Primary |
Addresses
Primary practice location
230A Main Street
Nettleton, MS 38855
Mailing address
110 N Main St
Collierville, TN 38017-2618
Phone (901) 221-2619
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
| License | State | Type | Specialty |
|---|---|---|---|
| 9998 | TN | MD | Social Worker |
| PT6113 | MS | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1402531200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1491955200000",
"number": "1962816447",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 N MAIN ST",
"city": "COLLIERVILLE",
"state": "TN",
"postal_code": "380172618",
"telephone_number": "901-221-2619",
"fax_number": "866-380-3102"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "230A MAIN STREET",
"city": "NETTLETON",
"state": "MS",
"postal_code": "38855",
"telephone_number": "662-591-7077",
"fax_number": "662-591-7078"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CASTLEBERRY",
"first_name": "TRAVIS",
"name_prefix": "Mr.",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-06-12",
"last_updated": "2017-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TN",
"license": "9998",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MS",
"license": "PT6113",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Nettleton, MS
- Access Family Health Services, Inc. (Access Community Pharmacy)
- Annie J Heyman (homeplace)
- Boa Vida Hospital of Aberdeen, Ms LLC (MRH Medical Group, Nettleton Express)
- Boa Vida Hospital of Aberdeen, Ms, LLC (MRH Medical Group, Nettleton)
- Breakthrough Physical Therapy
- Shelithea Darden, CPHT
- Katherine Elizabeth Davis, FNP-C
- Evergreen Clini
- Evergreen Family Medical Clinic Inc
- Family Care of Evergreen, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.