Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Sprout Pediatric Therapy, LLC

Organization Physical Therapist · NPI 1770060964

Sprout Pediatric Therapy, LLC is a Physical Therapist in Madison, Mississippi. Licensed in Mississippi. Registered with an NPI since 2018.

Licensed in
MS
In the registry since
2018
Specialties on file
3
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

108 Serenity Way
Madison, MS 39110-6992
Phone: (601) 831-2360
Fax: (601) 510-9735
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PT3255 (MS)
Occupational Therapist Taxonomy 225X00000X
Speech-Language Pathologist Taxonomy 235Z00000X

Record details

NPI number1770060964
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Emily Custer — Owner/Physical Therapist · (601) 831-2360
NPI enumeratedJuly 20, 2018
Last updated in NPPESJune 6, 2026
Certification dateJune 6, 2026
Mailing address108 Serenity Way, Madison, MS 39110-6992

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