Elite Physical Therapy, P.a.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT3345 Issued in MS

Legal business name

ELITE PHYSICAL THERAPY, P.A.

Practice address

113 Town Creek Dr
Saltillo, MS 38866

Phone

(662) 869-9980

NPI assigned

Jan 19, 2007

Last updated

Aug 22, 2020By 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

Mitchell Van Johnson, PT

Title

Owner

Phone

(662) 869-9980

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

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.

• Amber Alicia Bryant, M.S. CCC- SLP

  • Speech-Language Pathologist
  • Saltillo, MS
  • NPI 1912349002
  NPD (past)
• Lindsay Segars Duffie, PT

  • Physical Therapist
  • Saltillo, MS
  • NPI 1902139793
  NPD (past)

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972656288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 420",
            "city": "SALTILLO",
            "state": "MS",
            "postal_code": "388660420",
            "telephone_number": "662-869-9980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 TOWN CREEK DR",
            "city": "SALTILLO",
            "state": "MS",
            "postal_code": "38866",
            "telephone_number": "662-869-9980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE PHYSICAL THERAPY, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "MITCHELL",
        "authorized_official_middle_name": "VAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "662-869-9980",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT3345",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04185220",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dogwood Family Pharmacy Inc (Dogwood Family Pharmacy)
• Dogwood Homeplace
• Dpti Elite Physical Therapy LLC
• Lindsay Segars Duffie, PT
• Elite Physical Therapy
• Embrace Family Psychiatry and Wellness Inc
• Tara Engels
• Evolve Wellness LLC
• Family Urgent Care Clinic, PA
• Kristin Buskirk Foster, SLP

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.