Individual provider Active NPI

John Hudson IV, DPT

  • Physical Therapist
  • Jackson, MS
National Provider Identifier
1962994897
Registry record updated Mar 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT6193 Issued in MS
Practice address
1325 E Fortification St
Jackson, MS 39202-2442
Phone
(601) 354-4488
Fax
(601) 351-5980
NPI assigned
Jun 6, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2026

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 PT6193 MS Primary

Addresses

Primary practice location

1325 E Fortification St
Jackson, MS 39202-2442

Mailing address

1325 E Fortification St
Jackson, MS 39202-2442
Phone (601) 354-4488

Other practice location 1

2101 Highway 90
Gautier, MS 39553-5340
Phone (228) 471-1521

Other practice location 2

4010 Bienville Blvd Unit E
Ocean Springs, MS 39564-5990
Phone (228) 300-6001

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211101002102 MS Practitioner - Physical Therapist in Private Practice 9335537901 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mississippi Sports Medicine and Orthopaedic CenterGroup PAC ID 4981685310, 67 clinicians
Benchmark Physical Therapy of Mississippi LLCGroup PAC ID 0840626446, 12 clinicians

Practice addresses (Care Compare)

1325 E Fortification St
Jackson, MS 39202-2442
Phone (601) 354-4488

4010 Bienville Blvd
Ocean Springs, MS 39564-5988
Phone (228) 300-6001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT6193MSMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Benchmark Physical Therapy of Mississippi LLC Physical Therapist CurrentSince Dec 6, 2021 Accepting new patients
Agilitas USA Inc Physical Therapist CurrentSince Aug 16, 2024 Accepting new patients
Drayer Physical Therapy Mississippi LLC Physical Therapist CurrentSince Aug 16, 2024 Accepting new patients
Agilitas USA, Inc Physical Therapist CurrentSince Aug 16, 2024 Accepting new patients
Drayer Physical Therapy Mississippi LLC Physical Therapist Past Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

117 Bo Bo Dr
Crystal Springs, MS 39059
Phone (601) 892-6330

11516 Lamey Bridge Rd
Ste D
Diberville, MS 39540
Phone (228) 276-1459

4010 Bienville Blvd
Unit E
Ocean Springs, MS 39564
Phone (228) 300-6001

3451 Goodman Rd E
Ste 108
Southaven, MS 38672
Phone (662) 253-9060

Organizations & group practices 6

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": "1528243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774396800000",
    "number": "1962994897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 E FORTIFICATION ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022442",
            "telephone_number": "601-354-4488",
            "fax_number": "601-351-5980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 E FORTIFICATION ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022442",
            "telephone_number": "601-354-4488",
            "fax_number": "601-351-5980"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2101 Highway 90",
            "address_purpose": "LOCATION",
            "city": "Gautier",
            "state": "MS",
            "postal_code": "395535340",
            "country_code": "US",
            "telephone_number": "228-471-1521",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4010 Bienville Blvd Unit E",
            "address_purpose": "LOCATION",
            "city": "Ocean Springs",
            "state": "MS",
            "postal_code": "395645990",
            "country_code": "US",
            "telephone_number": "228-300-6001",
            "fax_number": "228-300-6005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUDSON",
        "first_name": "JOHN",
        "name_suffix": "IV",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-06",
        "last_updated": "2026-03-25",
        "certification_date": "2026-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT6193",
            "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 Mar 25, 2026; 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.