GOOD SAMARITAN PHYSICAL THERAPY,INC. (NPI# 1023087855) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023087855 |
| Entity Type | Organization |
| Organization Name | GOOD SAMARITAN PHYSICAL THERAPY,INC. |
| Practice Address |
1901 Mission 66 Suite A Vicksburg MS 39180-3711 |
| Mailing Address |
Po Box 822394 Vicksburg MS 39182-2394 |
| Practice Telephone | 6016384076 |
| Practice Fax Number | 6016384979 |
| Mailing Telephone | 6016384076 |
| Mailing Fax Number | 6016384979 |
| Enumeration Date | 2006-03-15 |
| Last Update Date | 2010-07-08 |
| Authorized Official Name | MRS. FERMIKA SMITH (BILLING MANAGER) |
| Authorized Official Telephone | 6016384076 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 332BN1400X |
Durable Medical Equipment & Medical Supplies Specialization: Nursing Facility Supplies |
Suppliers | ||
| N | 332BP3500X |
Durable Medical Equipment & Medical Supplies Specialization: Parenteral & Enteral Nutrition |
Suppliers | ||
| N | 332BC3200X |
Durable Medical Equipment & Medical Supplies Specialization: Customized Equipment |
Suppliers | ||
| N | 332BX2000X |
Durable Medical Equipment & Medical Supplies Specialization: Oxygen Equipment & Supplies |
Suppliers | ||
| Y | 261QR0401X |
Clinic/Center Specialization: Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
========= | MS | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | OWCP | 174112500 | 01 |
| MS | 09015117 | 05 | |
| MS | AETNA PROVIDER NUMBER | 5429586 | 01 |
| MS | DME | 4253810001 | 01 |
| MS | UNITED HEALTH CARE NUMBER | 6430026 | 01 |
| MS | BLUE CROSS NUMBER | 000050976 | 01 |
| LA | 1465739 | 05 |
| Street Address |
1901 MISSION 66 SUITE A |
| City | VICKSBURG |
| State | MS |
| Zip Code | 39180-3711 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922633916 | Physician Management Services of Mississippi, LLC | Family Medicine | 1901 Mission 66, Vicksburg, MS 39180-3711 | 2020-03-10 |
| 1417410911 | Cal-med LLC | Family Medicine | 1901 Mission 66, Vicksburg, MS 39180-3711 | 2019-04-11 |
| 1174067250 | Robert M Cannon Md LLC | Clinic/Center | 1901 Mission 66, Vicksburg, MS 39180-3711 | 2016-12-08 |
| 1659739787 | Denesia Y Giffin Pllc | Nurse Practitioner | 1901 Mission 66, Vicksburg, MS 39180-3711 | 2016-02-03 |
| 1710351572 | Alliance Healthcare Services Inc | Clinic/Center | 1901 Mission 66, Vicksburg, MS 39180-3711 | 2015-11-17 |
| 1588078737 | Christina Hossley Inc | Nurse Practitioner | 1901 Mission 66, Vicksburg, MS 39180-3711 | 2014-06-16 |
| 1639597966 | K Mcdaniel Inc | Nurse Practitioner | 1901 Mission 66, Vicksburg, MS 39180-3711 | 2014-04-03 |
| 1215373139 | Robert Michael Cannon | Family Medicine | 1901 Mission 66, Vicksburg, MS 39180-3711 | 2013-05-18 |
| 1326289612 | J Russell Barnes Md PC | Family Medicine | 1901 Mission 66, Vicksburg, MS 39180-3711 | 2009-03-16 |
| 1104088152 | Carlos Alberto Latorre | Family Medicine | 1901 Mission 66, Vicksburg, MS 39180-3711 | 2008-07-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255877346 | Elite Performance and Rehab, LLC | Clinic/Center | 1901 A Mission 66, Vicksburg, MS 39180 | 2017-01-12 |
| 1679931083 | Heather M Anderson | Physician Assistant | 2080 S Frontage Rd Ste 100, Vicksburg, MS 39180 | 2016-02-01 |
| 1245604941 | Warren County Assn.for Retarded Citizens, Inc. | Day Training, Developmentally Disabled Services | 100 Smokey Lane, Vicksburg, MS 39180 | 2015-11-18 |
| 1386012904 | Brian Oliver Snowden | Counselor | 3530 Manor Dr Ste 5a, Vicksburg, MS 39180 | 2015-09-14 |
| 1962802710 | Jordan P. Crocker, D.m.d., Pllc | Clinic/Center | 109 Monument Place, Vicksburg, MS 39180 | 2014-08-29 |
| 1821434259 | Trisha Addison | Physical Therapist | 2222 South Frontage Road, Suite D, Vicksburg, MS 39180 | 2013-05-13 |
| 1073862157 | Laura Jeanne Briggs | Physical Therapist | 1901-a Mission 66, Vicksburg, MS 39180 | 2012-09-05 |
| 1912175258 | Andrea T. Harris | Counselor | Warren-yazoo Mental Health Service, 3444 Wisconsin Ave., Vicksburg, MS 39180 | 2008-02-20 |
| 1922217314 | Austin Family Dentistry | Dentist | 3040 Indiana Ave, Vicksburg, MS 39180 | 2007-05-22 |
| 1063539138 | Ollie Hardaway Jr. | Dentist | 154 Cottonwood Street, Vicksburg, MS 39180 | 2007-03-23 |
| Find all providers in zip 39180 | ||||
| Taxonomy Code | 261QR0401X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497099683 | Pulmonary Diagnostic Services LLC | Clinic/Center | 114 Monument Pl, Vicksburg, MS 39180-5169 | 2012-11-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083047161 | New Life for Women, Inc. | Clinic/Center | 814 N Congress St, Jackson, MS 39202-2551 | 2013-08-13 |
| 1851620769 | Rippee Rehab Oxford, Inc | Clinic/Center | 2409 S. Lamar, Oxford, MS 38655-5344 | 2009-12-24 |
| 1245741388 | Synergy Therapy Services, Inc | Clinic/Center | 606 Belle Oak Ln, Brandon, MS 39042-8101 | 2017-10-16 |
Please comment or provide details below to improve the information on GOOD SAMARITAN PHYSICAL THERAPY,INC..
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.