Provider Demographics
NPI:1245453653
Name:ADAMS, JAMES D (DPT)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:D
Last Name:ADAMS
Suffix:
Gender:
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1561 ELLIS RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:38701-8800
Mailing Address - Country:US
Mailing Address - Phone:662-822-4229
Mailing Address - Fax:
Practice Address - Street 1:1561 ELLIS RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:MS
Practice Address - Zip Code:38701-8800
Practice Address - Country:US
Practice Address - Phone:662-822-4229
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSPT2502225100000X
ARPT 2640225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARPT2640OtherAR LIC
MS25383559Medicaid
13831477OtherCAQH
MSPT2502OtherMS LIC
524876ZWBLOtherPTAN
AR5AB50OtherBCBS
AR149491721Medicaid