NPIMap

Organization Active NPI

Flint Creek Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Wiggins, MS
National Provider Identifier
1972028520
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
PT4487 Issued in MS
Legal business name
FLINT CREEK PHYSICAL THERAPY, LLC
Practice address
321 Flora Gene Ave W Ste D
Wiggins, MS 39577-5008
Phone
(601) 523-1994
Fax
(601) 523-1995
NPI assigned
Aug 4, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mr. Ryan H Harrell, DPTNPI 1912130063
Title
Physical Therapist/Owner
Phone
(601) 528-1994

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X PT4487 MS Primary

Addresses

Primary practice location

321 Flora Gene Ave W Ste D
Wiggins, MS 39577-5008

Mailing address

321 Flora Gene Ave W Ste D
Wiggins, MS 39577-5008
Phone (601) 528-1994

National Provider Directory

National Provider Directory

Locations

321 Flora Gene Ave W
Ste D
Wiggins, MS 39577
Phone (601) 523-1994

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1501804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1972028520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 FLORA GENE AVE W STE D",
            "city": "WIGGINS",
            "state": "MS",
            "postal_code": "395775008",
            "telephone_number": "601-528-1994",
            "fax_number": "601-528-1995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 FLORA GENE AVE W STE D",
            "city": "WIGGINS",
            "state": "MS",
            "postal_code": "395775008",
            "telephone_number": "601-523-1994",
            "fax_number": "601-523-1995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLINT CREEK PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-04",
        "last_updated": "2022-07-21",
        "certification_date": "2021-02-04",
        "status": "A",
        "authorized_official_last_name": "HARRELL",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST/OWNER",
        "authorized_official_telephone_number": "601-528-1994",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MS",
            "license": "PT4487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wiggins, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.