SPORTY SPROUTS INC (NPI# 1780978502) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780978502 |
| Entity Type | Organization |
| Organization Name | SPORTY SPROUTS INC |
| Other Organization Name | SPORTY SPROUTS: YOUTH WELLNESS CENTER |
| Practice Address |
104 Faith Way Brandon MS 39042-8676 |
| Mailing Address |
Po Box 4233 Brandon MS 39047-4233 |
| Practice Telephone | 6018503698 |
| Mailing Telephone | 6018503698 |
| Enumeration Date | 2011-06-09 |
| Last Update Date | 2011-06-09 |
| Authorized Official Name | MR. BRANDON EUGENE HOLMES (CEO) |
| Authorized Official Telephone | 6018503698 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251P0200X |
Physical Therapist Specialization: Pediatrics |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Other Name | Type Code |
|---|---|
| Sporty Sprouts: Youth Wellness Center | Doing Business As Name - Organization |
| Street Address |
104 FAITH WAY |
| City | BRANDON |
| State | MS |
| Zip Code | 39042-8676 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740821529 | Claudia Francis Jones | Technician | 1008 Greenfield Circle, Brandon, MS 39042 | 2019-10-03 |
| 1194294546 | Allen Keith Johnson Jr. | Counselor | 1700 West Government Street Building B. Suite O., Brandon, MS 39042 | 2018-11-15 |
| 1689167462 | Regional Home Care and Infusions, Inc. | Registered Nurse | 302 Town Square, Suite 110, Brandon, MS 39042 | 2018-06-07 |
| 1013419563 | Brandon Family Chiropractic LLC | Chiropractor | 1350 West Government Street Suite A1, Brandon, MS 39042 | 2018-03-01 |
| 1184146789 | Lakeland Home Program LLC | Clinic/Center | 209 Mar Lyn Dr, Brandon, MS 39042 | 2017-07-14 |
| 1104275510 | Matthew Logue | Community Health Worker | 2009 Mossy Cove, Brandon, MS 39042 | 2016-06-07 |
| 1932569704 | Haley Wilson | Chiropractor | 1350 W Government St Ste A1, Brandon, MS 39042 | 2016-03-07 |
| 1548698608 | St Dominic Medical Associates LLC | Family Medicine | 1297 West Government Street, Brandon, MS 39042 | 2013-10-28 |
| 1760825434 | Linda J. Bridges | Respiratory Therapist, Certified | 330 Rankin Road, Brandon, UNITED STATES 39042 | 2013-04-12 |
| 1861739922 | Georgia Christine Shirley | Nurse Practitioner | 2008 Brookstone Place, Brandon, MS 39042 | 2013-01-09 |
| Find all providers in zip 39042 | ||||
| Taxonomy Code | 2251P0200X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174721047 | Kimberly Garrett Cooper | Physical Therapist | 112 Riverbend Cv, Brandon, MS 39047-8647 | 2007-07-03 |
| 1124545892 | Nadia Gaddis | Physical Therapist | 206 Ridgewood Ave, Brandon, FL 33510-4617 | 2017-08-24 |
| 1205177979 | Jane Levine | Physical Therapist | 602 Vonderburg Dr, Suite 201, Brandon, FL 33511-5900 | 2013-03-06 |
| 1912294232 | Jared Patrick Reites | Physical Therapist | 885 S Parsons Ave, Brandon, FL 33511-6063 | 2011-07-07 |
| 1053579557 | Marie Swaney Schaffnit | Physical Therapist | 206 Ridgewood Ave, Brandon, FL 33510-4617 | 2008-05-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376916544 | Tracie Lee Thornton | Physical Therapist | 11 Dempsey Conn Rd, Hattiesburg, MS 39401-9041 | 2015-11-09 |
| 1407270333 | Creative Connections, Pllc | Physical Therapist | 4094 W Topisaw S, Summit, MS 39666-9785 | 2014-02-12 |
| 1184976037 | Kalyn Mcnair Dragon | Physical Therapist | 11845 River Estates Cir, Biloxi, MS 39532-8603 | 2012-10-02 |
| 1962739722 | Coastal Plains Interagency Coordinating Council | Physical Therapist | 4063 Ginger Drie, Suite A, D'lberville, MS 39540-3705 | 2009-11-15 |
| 1447371877 | Bethany B. Dill | Physical Therapist | 3815 Beauville Cv, Ocean Springs, MS 39564-8583 | 2007-04-03 |
| 1417560913 | Mckenzie Alexandra Mcclanahan | Physical Therapist | 1751 Dancy Blvd Ste 2, Horn Lake, MS 38637-1916 | 2020-08-25 |
| 1629680277 | Elizabeth Sueing C Sueing | Physical Therapist | 83 Airways Pl, Southaven, MS 38671-5885 | 2020-08-17 |
| 1336758267 | Rachel Blake Tyrone | Physical Therapist | 83 Airways Pl, Southaven, MS 38671-5885 | 2020-07-27 |
| 1245871664 | Kari Schumann | Physical Therapist | 83 Airways Pl, Southaven, MS 38671-5885 | 2019-10-07 |
| 1740835008 | Karla Easterling | Physical Therapist | 1050 N Flowood Dr, Flowood, MS 39232-9738 | 2019-08-05 |
| Find all providers with the same taxonomy | ||||
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| 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.