Dr. Jasper Winton Adcock specialises in Physical Therapy. He currently works in Mississippi.
NPI Number | 1942556311 |
Provider Name | Jasper Winton Adcock |
Credential | |
Specialization | Physical Therapy |
Medical School Name | Other |
Graduation Year | 2011 |
Gender | M |
Entity Type | Individual |
PAC ID by PECOS | 5890059612 |
Professional Enrollment ID | I20210310001448 |
Enumeration Date | 08/03/2012 |
Last Update Date | 02/23/2022 |
Business Practice address |
1074 HIGHWAY 13 N, Brandon, 39042-8568 Mississippi View on Google Map |
Business Practice phone | 601-825-0101 |
Business Practice fax | 601-825-0102 |
Mailing address |
PO BOX 1577, Magee, 39111-1577 Mississippi View on Google Map |
Other phone | 601-722-2222 |
Other fax | 601-722-4444 |
Email Address | shannonfig@domain.com Reval Email Address |
Brandon, Mississippi
Physical Therapy, 2011
Organization Name | PECOS PAC ID | Members | |
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Actimed, Llc | 1850642547 | 3 |
Field Name | Field Value |
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NPI | 1942556311 |
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. | |
Entity Type | Individual |
Code describing the type of health care provider that is being assigned an NPI. Codes are:
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Is Sole Proprietor | Y |
Indicate whether provider is a sole proprietor.
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Provider Last Name (Legal Name) | Adcock |
The last name of the provider (if an individual). If the provider is an individual, this is the legal name. This name must match the name on file with the Social Security Administration (SSA). In addition, the date of birth must match that on file with SSA. (First and last names are required for initial applications.) The First, Middle, Last and Credential(s) fields allow the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. | |
Provider First Name | Jasper |
The first name of the provider, if the provider is an individual. | |
Provider Credential Text | DPT, OTR/L, RHIA |
The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS. | |
Provider First Line Business Mailing Address | PO BOX 1577 |
The first line mailing address of the provider being identified. This data element may contain the same information as ''Provider first line location address''. | |
Provider Business Mailing Address City Name | Magee |
The City name in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address City name''. | |
Provider Business Mailing Address State Name | Mississippi |
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address State name''. | |
Provider Business Mailing Address Postal Code | 39111-1577 |
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ''Provider location address postal code''. | |
Provider Business Mailing Address Country Code | US |
The country code in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address country code''. | |
Provider Business Mailing Address Telephone Number | 601-722-2222 |
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ''Provider location address telephone number''. | |
Provider Business Mailing Address Fax Number | 601-722-4444 |
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address fax number''. | |
Provider First Line Business Practice Location Address | 1074 HIGHWAY 13 N |
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box. | |
Provider Business Practice Location Address City Name | Brandon |
The city name in the location address of the provider being identified. | |
Provider Business Practice Location Address State Name | Mississippi |
The State or Province name in the location address of the provider being identified. | |
Provider Business Practice Location Address Postal Code | 39042-8568 |
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. | |
Provider Business Practice Location Address Country Code | US |
The country code in the location address of the provider being identified. | |
Provider Business Practice Location Address Telephone Number | 601-825-0101 |
The telephone number associated with the location address of the provider being identified. | |
Provider Business Practice Location Address Fax Number | 601-825-0102 |
The fax number associated with the location address of the provider being identified. | |
Provider Enumeration Date | 08/03/2012 |
The date the provider was assigned a unique identifier (assigned an NPI). | |
Last Update Date | 02/23/2022 |
The date that a record was last updated or changed. | |
Provider Gender Code | M |
The code designating the provider's gender if the provider is a person. | |
Provider Gender | Male |
The provider's gender if the provider is a person. | |
Healthcare Provider Taxonomy Code #1 | 261QP2000X |
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization. | |
Healthcare Provider Taxonomy 1 | An entity, facility, or distinct part of a facility providing diagnostic and treatment services related to physical rehabilitation. Physical therapy is a dynamic profession with an established theoretical and scientific base and widespread clinical applications in the restoration, maintenance, and promotion of optimal physical function. Physical therapists and physical therapist assistants are licensed health care professionals who are experts in the movement system and help individuals maintain, restore, and improve movement, activity, and functioning, thereby enabling optimal performance and enhancing health, well-being, and quality of life. Their services prevent, minimize, or eliminate impairments of body functions and structures, activity limitations, and participation restrictions. Physical therapy is provided for individuals of all ages who have or may develop impairments, activity limitations, and participation restrictions related to (1) conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems or (2) the negative effects attributable to unique personal and environmental factors as they relate to human performance. |
Healthcare Provider Taxonomy #1 | |
Provider License Number 1 | 5208 |
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section. | |
Provider License Number State Code 1 | MS |
Provider License Number State Code #1 | |
Healthcare Provider Primary Taxonomy Switch 1 | N |
Primary Taxonomy:
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Healthcare Provider Taxonomy Code #2 | 225X00000X |
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization. | |
Healthcare Provider Taxonomy 2 | An occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, or approved by the World Federation of Occupational Therapists (WFOT), or an equivalent international occupational therapy education program; has successfully completed a period of supervised fieldwork experience required by the occupational therapy program; has passed a nationally recognized entry-level examination for occupational therapists, and fulfills state requirements for licensure, certification, or registration. An occupational therapist provides interventions based on evaluation and which emphasize the therapeutic use of everyday life activities (i.e., occupations) with individuals or groups for the purpose of facilitating participation in roles and situations and in home, school, workplace, community and other settings. Occupational therapy services are provided for the purpose of promoting health and wellness and are provided to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapists address the physical, cognitive, psychosocial, sensory, and other aspects of occupational performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life. |
Healthcare Provider Taxonomy #2 | |
Provider License Number 2 | 2664 |
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section. | |
Provider License Number State Code 2 | MS |
Provider License Number State Code #2 | |
Healthcare Provider Primary Taxonomy Switch 2 | Y |
Primary Taxonomy:
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Healthcare Provider Taxonomy Code #3 | 2255A2300X |
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization. | |
Healthcare Provider Taxonomy 3 | Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor's degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration. |
Healthcare Provider Taxonomy #3 | |
Provider License Number State Code 3 | MS |
Provider License Number State Code #3 | |
Healthcare Provider Primary Taxonomy Switch 3 | N |
Primary Taxonomy:
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Healthcare Provider Taxonomy Code #4 | 225100000X |
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization. | |
Healthcare Provider Taxonomy 4 | Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles. PTs: 1.Diagnose and manage movement dysfunction and enhance physical and functional abilities. 2.Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health. 3.Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries. 4.Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems. 5.Address the negative effects attributable to unique personal and environmental factors as they relate to human performance. 6.PTs provide care for people in a variety of settings, including hospitals, private practices, outpatient clinics, home health agencies, schools, sports and fitness facilities, work settings, and nursing homes. State licensure is required in each state in which a PT practices. |
Healthcare Provider Taxonomy #4 | |
Provider License Number 4 | 5208 |
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section. | |
Provider License Number State Code 4 | MS |
Provider License Number State Code #4 | |
Healthcare Provider Primary Taxonomy Switch 4 | N |
Primary Taxonomy:
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Healthcare Provider Taxonomy Group 4 | 193200000X MULTI-SPECIALTY GROUP |
Healthcare Provider Taxonomy Group 4 | |
Healthcare Provider Taxonomy Code #5 | 225700000X |
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization. | |
Healthcare Provider Taxonomy 5 | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |
Healthcare Provider Taxonomy #5 | |
Provider License Number State Code 5 | MS |
Provider License Number State Code #5 | |
Healthcare Provider Primary Taxonomy Switch 5 | N |
Primary Taxonomy:
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Healthcare Provider Taxonomy Code #6 | 235Z00000X |
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization. | |
Healthcare Provider Taxonomy 6 | The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing. |
Healthcare Provider Taxonomy #6 | |
Provider License Number State Code 6 | MS |
Provider License Number State Code #6 | |
Healthcare Provider Primary Taxonomy Switch 6 | N |
Primary Taxonomy:
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Healthcare Provider Taxonomy Group 6 | 193200000X MULTI-SPECIALTY GROUP |
Healthcare Provider Taxonomy Group 6 | |
Healthcare Provider Taxonomy Code #7 | 261QP2000X |
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization. | |
Healthcare Provider Taxonomy 7 | An entity, facility, or distinct part of a facility providing diagnostic and treatment services related to physical rehabilitation. Physical therapy is a dynamic profession with an established theoretical and scientific base and widespread clinical applications in the restoration, maintenance, and promotion of optimal physical function. Physical therapists and physical therapist assistants are licensed health care professionals who are experts in the movement system and help individuals maintain, restore, and improve movement, activity, and functioning, thereby enabling optimal performance and enhancing health, well-being, and quality of life. Their services prevent, minimize, or eliminate impairments of body functions and structures, activity limitations, and participation restrictions. Physical therapy is provided for individuals of all ages who have or may develop impairments, activity limitations, and participation restrictions related to (1) conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems or (2) the negative effects attributable to unique personal and environmental factors as they relate to human performance. |
Healthcare Provider Taxonomy #7 | |
Provider License Number 7 | 2664 |
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section. | |
Provider License Number State Code 7 | MS |
Provider License Number State Code #7 | |
Healthcare Provider Primary Taxonomy Switch 7 | N |
Primary Taxonomy:
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Healthcare Provider Taxonomy Code #8 | 261QP2000X |
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization. | |
Healthcare Provider Taxonomy 8 | An entity, facility, or distinct part of a facility providing diagnostic and treatment services related to physical rehabilitation. Physical therapy is a dynamic profession with an established theoretical and scientific base and widespread clinical applications in the restoration, maintenance, and promotion of optimal physical function. Physical therapists and physical therapist assistants are licensed health care professionals who are experts in the movement system and help individuals maintain, restore, and improve movement, activity, and functioning, thereby enabling optimal performance and enhancing health, well-being, and quality of life. Their services prevent, minimize, or eliminate impairments of body functions and structures, activity limitations, and participation restrictions. Physical therapy is provided for individuals of all ages who have or may develop impairments, activity limitations, and participation restrictions related to (1) conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems or (2) the negative effects attributable to unique personal and environmental factors as they relate to human performance. |
Healthcare Provider Taxonomy #8 |