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FUNDAMENTAL THERAPY LLC
NPI 1659796860
Specialist in Picayune, MS

Active since February 25, 2014
311 N MAIN ST, PICAYUNE, MS 39466(601) 799-4065(601) 620-4117 Get Directions Write a Review

NPPES record last updated: January 10, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Fundamental Therapy Llc NPPES

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

FUNDAMENTAL THERAPY LLC (NPI 1659796860) is a healthcare organization registered as a specialist in Picayune, Mississippi and active in the NPI registry since February 2014. The organization lists Sara Carr Braddy, Occupational Therapist, as its authorized official.

NPPES Registry Identity

NPI1659796860
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameFUNDAMENTAL THERAPY LLC
Location Address311 N MAIN STPicayune, MS 39466-3313
Mailing Address20 Newt Mitchell RdPicayune, MS 39466-9224
Phone(601) 799-4065
Fax(601) 620-4117
Organization SubpartNo
Authorized OfficialSara Carr BraddyOccupational Therapist · (601) 916-8329
Enumeration DateFebruary 25, 2014
Last NPPES UpdateJanuary 10, 2015
✔ NPI 1659796860 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in MS · OT2316
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
311 N MAIN ST, Picayune, MS 39466
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Other Identifiers 1

Medicaid05587048MS

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 4

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

MRS. KARLY MITCHELL SLADE COTA/L
Occupational Therapy Assistant
311 N MAIN ST
PICAYUNE, MS 39466
Pearl River County (601) 799-4065
FUNCTIONAL THERAPY LLC
Occupational Therapist
311 N MAIN ST
PICAYUNE, MS 39466
Pearl River County (601) 799-4065
MRS. STACEY S VOLLENWEIDER OTR/L
Occupational Therapist
311 N MAIN ST
PICAYUNE, MS 39466
Pearl River County (601) 799-4065
MRS. SARA C BRADDY MOTR/L
Occupational Therapist
311 N MAIN ST
PICAYUNE, MS 39466
Pearl River County (601) 799-4065

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 Fundamental Therapy LLC's NPI number?

The NPI number for Fundamental Therapy LLC is 1659796860. It was assigned to this organization in the NPPES registry on February 25, 2014.

Where is Fundamental Therapy LLC located?

Fundamental Therapy LLC is located at 311 N Main St, Picayune, MS 39466. The listed phone number is (601) 799-4065.

What is Fundamental Therapy LLC's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Fundamental Therapy LLC was last updated on January 10, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.