Sog Physical Therapy - Medicare Primary Care in Tupelo, MS

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Sog Physical Therapy is a medicare enrolled primary clinic (Clinic/center - Multi-specialty) in Tupelo, Mississippi. The current practice location for Sog Physical Therapy is 1211 S Gloster St Ste C, Tupelo, Mississippi. For appointments, you can reach them via phone at (662) 767-4200. The mailing address for Sog Physical Therapy is 1211 S Gloster St, Tupelo, Mississippi and phone number is (662) 432-1523.

Sog Physical Therapy is licensed to practice in (license number ). The clinic also participates in the medicare program and its NPI number is 1902361660. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (662) 767-4200.

Contact Information

Sog Physical Therapy
1211 S Gloster St Ste C
Tupelo
MS 38801-6535
(662) 767-4200
(767) 420-4662

Map and Direction


Primary Care Clinic Profile

Full NameSog Physical Therapy
SpecialityClinic/Center
Location1211 S Gloster St Ste C, Tupelo, Mississippi
Authorized Official Name and PositionThomas Luster (CEO)
Authorized Official Contact6627674200
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Sog Physical Therapy
1211 S Gloster St
Tupelo
MS 38801-6546

Ph: (662) 432-1523		Sog Physical Therapy
1211 S Gloster St Ste C
Tupelo
MS 38801-6535

Ph: (662) 767-4200

NPI Details:

NPI Number1902361660
Provider Enumeration Date02/07/2019
Last Update Date09/03/2024
Certification Date09/03/2024

Medicare PECOS Information:

Medicare PECOS PAC ID1850627209
Medicare Enrollment IDO20190724000229

Medical Identifiers

Medical identifiers for Sog Physical Therapy such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1902361660NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
261QM1300XClinic/center - Multi-specialty ()Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Sog Physical Therapy acts as a billing entity for following providers:
Provider NameGabrielle Chiniche
Provider TypePractitioner - Occupational Therapist In Private Practice
Provider IdentifiersNPI Number: 1003842758
PECOS PAC ID: 9830108455
Enrollment ID: I20060824000450
Provider NamePaul a Kosko
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1871722173
PECOS PAC ID: 3375697766
Enrollment ID: I20090819000788
Provider NameAndrea B Spencer
Provider TypePractitioner - Occupational Therapist In Private Practice
Provider IdentifiersNPI Number: 1093066078
PECOS PAC ID: 0345491759
Enrollment ID: I20121113000173
Provider NameJordan L Hill
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1659789485
PECOS PAC ID: 8527289586
Enrollment ID: I20141016002312
Provider NameDonna B Buchanan
Provider TypePractitioner - Occupational Therapist In Private Practice
Provider IdentifiersNPI Number: 1093157570
PECOS PAC ID: 3870919434
Enrollment ID: I20200813002565
Provider NameChristy L Flynn
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1932543055
PECOS PAC ID: 1456779560
Enrollment ID: I20200921003194
Provider NameCollin Sanders
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1720693245
PECOS PAC ID: 8527488659
Enrollment ID: I20201012001497
Provider NameTaylor Irby Collins
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1831745397
PECOS PAC ID: 7517299357
Enrollment ID: I20210119000897
Provider NameJames Ryan Wall
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1962071050
PECOS PAC ID: 9335540988
Enrollment ID: I20210702000945
Provider NameCaley O'callaghan Speck
Provider TypePractitioner - Occupational Therapist In Private Practice
Provider IdentifiersNPI Number: 1003341462
PECOS PAC ID: 6608265194
Enrollment ID: I20211123001609
Provider NameJoseph Cason Collins
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1184353237
PECOS PAC ID: 0648659953
Enrollment ID: I20220616001413
Provider NameMichael Pannell
Provider TypePractitioner - Occupational Therapist In Private Practice
Provider IdentifiersNPI Number: 1083241442
PECOS PAC ID: 6901221613
Enrollment ID: I20240514002945
Provider NameMichael Scott Childers
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1144061706
PECOS PAC ID: 8022555374
Enrollment ID: I20240805000233
Provider NameMiranda White
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1033913587
PECOS PAC ID: 0749706307
Enrollment ID: I20250828000974
Provider NameKentron Gibson
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1669266904
PECOS PAC ID: 7810413390
Enrollment ID: I20250829000512
Provider NameHaley Walker Heyer
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1881570950
PECOS PAC ID: 0345742086
Enrollment ID: I20250903003199
Provider NameTrevor Koplitz
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1912523911
PECOS PAC ID: 3173942471
Enrollment ID: I20250910001214
Provider NameLeslie Johnston
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1831503127
PECOS PAC ID: 1153825799
Enrollment ID: I20250917003146
Provider NameMary Margaret Crowson
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1033407044
PECOS PAC ID: 0941791545
Enrollment ID: I20251111003904
Provider NameMargaret Hargrove Miller
Provider TypePractitioner - Occupational Therapist In Private Practice
Provider IdentifiersNPI Number: 1114175700
PECOS PAC ID: 1557414398
Enrollment ID: I20251212002046
Provider NameAbigail Tidwell
Provider TypePractitioner - Occupational Therapist In Private Practice
Provider IdentifiersNPI Number: 1023798733
PECOS PAC ID: 6507210275
Enrollment ID: I20260126000970
Provider NameSheri Gibson
Provider TypePractitioner - Occupational Therapist In Private Practice
Provider IdentifiersNPI Number: 1912486606
PECOS PAC ID: 7416436944
Enrollment ID: I20260205001404
Provider NameCameron Ashley Tubb
Provider TypePractitioner - Occupational Therapist In Private Practice
Provider IdentifiersNPI Number: 1770373565
PECOS PAC ID: 8921589623
Enrollment ID: I20260220001745

Reviews and Comments

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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.