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GOOD SAMARITAN PHYSICAL THERAPY,INC.
NPI 1023087855
Clinic/Center - Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) in Vicksburg, MS

Active since March 15, 2006
1901 MISSION 66, SUITE A, VICKSBURG, MS 39180(601) 638-4076(601) 638-4979 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Good Samaritan Physical Therapy,inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GOOD SAMARITAN PHYSICAL THERAPY,INC. (NPI 1023087855) is a healthcare organization registered as a rehabilitation, comprehensive outpatient rehabilitation facility (corf) in Vicksburg, Mississippi and active in the NPI registry since March 2006. The organization lists Fermika Smith, Billing Manager, as its authorized official.

NPPES Registry Identity

NPI1023087855
Entity TypeOrganization
Primary Taxonomy261QR0401X
Legal Business NameGOOD SAMARITAN PHYSICAL THERAPY,INC.
Location Address1901 MISSION 66, SUITE AVicksburg, MS 39180-3711
Mailing AddressPo Box 822394Vicksburg, MS 39182-2394 · (601) 638-4076 · Fax (601) 638-4979
Phone(601) 638-4076
Fax(601) 638-4979
Organization SubpartNo
Authorized OfficialFermika SmithBilling Manager · (601) 638-4076
Enumeration DateMarch 15, 2006
Last NPPES UpdateJuly 21, 2022
✔ NPI 1023087855 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 6

★ Primary SpecialtyClinic/Center · Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)Ambulatory Health Care Facilities
Taxonomy Code261QR0401X
Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
Also ListedDurable Medical Equipment & Medical Supplies · Customized EquipmentTaxonomy 332BC3200X
Also ListedDurable Medical Equipment & Medical Supplies · Nursing Facility SuppliesTaxonomy 332BN1400X
Also ListedDurable Medical Equipment & Medical Supplies · Parenteral & Enteral NutritionTaxonomy 332BP3500X
Also ListedDurable Medical Equipment & Medical Supplies · Oxygen Equipment & SuppliesTaxonomy 332BX2000X
1901 MISSION 66, Vicksburg, MS 39180
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Other Identifiers 7

Other6430026MS · United Health Care Number
Other000050976MS · Blue Cross Number
Other174112500MS · Owcp
Medicaid09015117MS
Other5429586MS · Aetna Provider Number
Other4253810001MS · Dme
Medicaid1465739LA

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ROBERT C MASTERSON DO
Family Medicine
1901 MISSION 66
VICKSBURG, MS 39180
Warren County (601) 636-8244
CARLOS ALBERTO LATORRE M.D.
Family Medicine
1901 MISSION 66
VICKSBURG, MS 39180
Warren County (601) 636-0097
ROBERT M CANNON MD LLC
Clinic/Center (Primary Care)
1901 MISSION 66
VICKSBURG, MS 39180
Warren County (601) 636-0097
FLOWERS MEDICAL GROUP LLC
Family Medicine
1901 MISSION 66
VICKSBURG, MS 39180
Warren County (601) 636-0097
JOHN R BARNES MD
Family Medicine
1901 MISSION 66
VICKSBURG, MS 39180
Warren County (601) 636-0097
DR. ROBERT MICHAEL CANNON M.D.
Family Medicine
1901 MISSION 66
VICKSBURG, MS 39180
Warren County (601) 636-0097
HOLLY PITTMAN OT
Occupational Therapist
1901 MISSION 66, SUITE A
VICKSBURG, MS 39180
Warren County (601) 638-4076
THERESA SHELLY KING RCP
Respiratory Therapist, Certified (General Care)
1901 MISSION 66, SUITE A
VICKSBURG, MS 39180
Warren County (601) 638-4076

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Good Samaritan Physical Therapy,inc.'s NPI number?

The NPI number for Good Samaritan Physical Therapy,inc. is 1023087855. It was assigned to this organization in the NPPES registry on March 15, 2006.

Where is Good Samaritan Physical Therapy,inc. located?

Good Samaritan Physical Therapy,inc. is located at 1901 Mission 66 Suite A, Vicksburg, MS 39180. The listed phone number is (601) 638-4076.

What is Good Samaritan Physical Therapy,inc.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF), with taxonomy code 261QR0401X.

When was this NPI record last updated?

The NPPES record for Good Samaritan Physical Therapy,inc. was last updated on July 21, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.