SOG PHYSICAL THERAPY (NPI# 1902361660) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902361660 |
| Entity Type | Organization |
| Organization Name | SOG PHYSICAL THERAPY |
| Practice Address |
1211 S Gloster St Ste C Tupelo MS 38801-6535 |
| Mailing Address |
199 N Brookmoore Dr Columbus MS 39705-2024 |
| Practice Telephone | 6627674200 |
| Practice Fax Number | 7674204662 |
| Mailing Telephone | 6623276705 |
| Mailing Fax Number | 6623276760 |
| Enumeration Date | 2019-02-07 |
| Last Update Date | 2019-02-07 |
| Authorized Official Name | THOMAS LUSTER (CEO) |
| Authorized Official Telephone | 6627674200 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| Street Address |
1211 S GLOSTER ST STE C |
| City | TUPELO |
| State | MS |
| Zip Code | 38801-6535 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215244066 | Emily B Mccafferty | Physical Therapist | 1211 S Gloster St Ste C, Tupelo, MS 38801-6548 | 2010-08-31 |
| 1720693245 | Collin Sanders | Physical Therapist | 1211 S Gloster St Ste C, Tupelo, MS 38801-6548 | 2020-09-11 |
| 1700431004 | Taylor M Brown | Physical Therapist | 1211 S Gloster St Ste C, Tupelo, MS 38801-6548 | 2019-08-05 |
| 1790346757 | Callie Andersen | Physical Therapy Assistant | 1211 S Gloster St Ste C, Tupelo, MS 38801-6535 | 2019-06-21 |
| 1881076362 | Cody L Pounders | Occupational Therapist | 1211 S Gloster St Ste C, Tupelo, MS 38801-6548 | 2015-06-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194339275 | Friendship, LLC | Pharmacy | 4123 W Main St, Tupelo, MS 38801 | 2020-09-04 |
| 1003443458 | Nicole Sherice Taylor | Nurse Practitioner | 845 South Gloster Street, Tupelo, MS 38801 | 2020-03-25 |
| 1821556838 | Wilco Healthcare of North Mississippi, Pllc | Point of Service | 1514 Co Rd 41, Tupelo, MS 38801 | 2019-03-08 |
| 1821565235 | Stephanie K Cagle | Nurse Practitioner | 218 S Thomas St Ste 120-121, Tupelo, MS 38801 | 2018-10-24 |
| 1073092326 | Lauren Parrish | Nurse Practitioner | 1573 Medical Park Circle, Tupelo, MS 38801 | 2018-08-08 |
| 1467948687 | North Mississippi Medcial Center, Inc. | Nurse Practitioner | 990 S Madison St Ste 2, Tupelo, MS 38801 | 2018-07-11 |
| 1043700933 | Hooks Diabetes & Medicine Clinic | Non-Pharmacy Dispensing Site | 2610 Traceland Drive, Ste A, Tupelo, MS 38801 | 2018-05-16 |
| 1073035903 | Annette C Riddle | Counselor | 1004 Eisenhower Drive, Tupelo, MS 38801 | 2017-07-12 |
| 1548709678 | Jaime Summers | Nurse Practitioner | 2780 West Jackson St, Tupelo, MS 38801 | 2017-02-22 |
| 1073975611 | Heath Bryan Coleman, Dds of Mississippi II, Pllc | Dentist | 1168 Cross Creek Drive, Tupelo, MS 38801 | 2016-03-23 |
| Find all providers in zip 38801 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679903546 | Northeast Mental Health-mental Retardation Commission | Clinic/Center | 499 Gloster Creek Vlg, Suite A-3, Tupelo, MS 38801-4600 | 2013-11-13 |
| 1548413628 | Northeast Mental Health-mental Retardation Commission | Clinic/Center | 2434 S Eason Blvd, Tupelo, MS 38804-6942 | 2008-11-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487201372 | Caleb Mountain Climbing Wholistic International Center LLC | Clinic/Center | 610 Adeline St Ste 1a, Hattiesburg, MS 39401-3875 | 2019-08-24 |
| 1700440369 | Gentle Hands Healthcare LLC | Clinic/Center | 135 Oak Meadow Dr, Clinton, MS 39056-6044 | 2019-04-29 |
| 1629530795 | A Port In The Storm (apits) | Clinic/Center | 102 N. Cass Street, Suite B, Corinth, MS 38834 | 2019-04-05 |
| 1730502055 | Hancock Medical Health Services | Clinic/Center | 5435 Gex Road, Diamondhead, MS 39525 | 2014-01-22 |
| 1538478870 | Hancock Medical Health Services, Inc. | Clinic/Center | 100 Hancock Square Dr, Bay St Louis, MS 39520-1632 | 2010-10-05 |
| 1629287719 | Singing River Health System | Clinic/Center | 7001 Highway 614, Moss Point, MS 39562 | 2007-05-22 |
| 1164422580 | Mississippi University for Women | Clinic/Center | 620 10th St South, Cromwell Bldg Room 129, Columbus, MS 39701 | 2005-07-28 |
| 1578129177 | Madison Hma LLC | Clinic/Center | 161 River Oaks Dr, Canton, MS 39046-5375 | 2019-05-20 |
| 1558897744 | Asa LLC | Clinic/Center | 1924 30th Ave, Gulfport, MS 39501-4534 | 2017-05-07 |
| 1295261642 | Quality Medical Clinic II, LLC | Clinic/Center | 101 Hospital Dr, Tylertown, MS 39667-2021 | 2017-05-04 |
| 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.