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SPORTY SPROUTS: YOUTH WELLNESS CENTER
NPI 1780978502
Physical Therapist - Pediatrics in Brandon, MS

Active since June 09, 2011
104 FAITH WAY, BRANDON, MS 39042(601) 850-3698 Get Directions Write a Review

NPPES record last updated: June 9, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Sporty Sprouts: Youth Wellness Center NPPES

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

SPORTY SPROUTS: YOUTH WELLNESS CENTER (NPI 1780978502) is a healthcare organization registered as a pediatrics in Brandon, Mississippi and active in the NPI registry since June 2011. The organization lists Brandon Eugene Holmes, Ceo, as its authorized official.

NPPES Registry Identity

NPI1780978502
Entity TypeOrganization
Primary Taxonomy2251P0200X
Legal Business NameSPORTY SPROUTS INC
Location Address104 FAITH WAYBrandon, MS 39042-8676
Mailing AddressPo Box 4233Brandon, MS 39047-4233 · (601) 850-3698
Phone(601) 850-3698
Organization SubpartNo
Authorized OfficialBrandon Eugene HolmesCeo · (601) 850-3698
Enumeration DateJune 9, 2011
✔ NPI 1780978502 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysical Therapist · PediatricsRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code2251P0200X
Definition
A licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Pediatric Physical Therapy, who has demonstrated specialized knowledge and skill in anatomy, histology, including embryonic development, genetics, biomechanics, neurological function, neuroscience, and pathology, behavioral sciences, and understanding of diseases or conditions that necessitate physical therapy care, that affect systems that in turn necessitate physical therapy care (comorbidities), and that influence the type of intervention that can be given.
104 FAITH WAY, Brandon, MS 39042
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Other Names 1

Doing Business AsSporty Sprouts: Youth Wellness Center

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

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 Sporty Sprouts Inc's NPI number?

The NPI number for Sporty Sprouts Inc is 1780978502. It was assigned to this organization in the NPPES registry on June 9, 2011. The provider is doing business as Sporty Sprouts: Youth Wellness Center.

Where is Sporty Sprouts Inc located?

Sporty Sprouts Inc is located at 104 Faith Way, Brandon, MS 39042. The listed phone number is (601) 850-3698.

What is Sporty Sprouts Inc's specialty?

The primary specialty registered for this NPI is Physical Therapist, specializing in Pediatrics, with taxonomy code 2251P0200X.

When was this NPI record last updated?

The NPPES record for Sporty Sprouts Inc was last updated on June 9, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.