Individual provider Active NPI

Quincy Harvey, PT

  • Physical Therapist
  • Ridgeland, MS
National Provider Identifier
1992199509
Registry record updated Mar 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT5556 Issued in MS
Practice address
711 Avignon Dr
Ridgeland, MS 39157-5120
Phone
(601) 605-6777
Fax
(479) 968-4331
NPI assigned
Mar 20, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2015

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 PT5556 MS Primary

Addresses

Primary practice location

711 Avignon Dr
Ridgeland, MS 39157-5120

Mailing address

PO Box 9178
Russellville, AR 72811-9178
Phone (479) 498-6700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161202000035 MS Practitioner - Physical Therapist in Private Practice 0547540833 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gptrs IIGroup PAC ID 2860527108, 4 clinicians

Practice addresses (Care Compare)

4812 Lakeland Dr
Flowood, MS 39232-8694
Phone (601) 983-1200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT5556MSMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Gptrs II Physical Therapist CurrentSince Apr 7, 2023 Accepting new patients
Genesis Physical Therapy & Rehabilitation LLC Physical Therapist PastSince Apr 7, 2023 Accepting new patients
Enduracare Acute Care Services LLC Physical Therapist Past Accepting new patients

Locations

4812 Lakeland Dr
Flowood, MS 39232
Phone (601) 608-3223

308 Corporate Dr
Ridgeland, MS 39157
Phone (601) 898-7500

227 Highway 51
Ridgeland, MS 39157
Phone (601) 898-4324

Organizations & group practices 3

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": "1426809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426809600000",
    "number": "1992199509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9178",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728119178",
            "telephone_number": "479-498-6700",
            "fax_number": "479-968-4331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 AVIGNON DR",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391575120",
            "telephone_number": "601-605-6777",
            "fax_number": "479-968-4331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARVEY",
        "first_name": "QUINCY",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-03-20",
        "last_updated": "2015-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT5556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgeland, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2015; 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.