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

Blake Jordan Falconello, DPT

Individual provider Physical Therapist · NPI 1104593599

Blake Jordan Falconello, DPT is a Physical Therapist in Private Practice in Olive Branch, Mississippi. Qualified in 2021, 5 years ago. Practices with Huling Physical Therapy LLC, a 2-clinician group and accepts Medicare assignment. Licensed in Tennessee.

Years since qualifying
5
Licensed in
TN
In the registry since
2021
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

6542 Goodman Rd Ste 101
Olive Branch, MS 38654-5559
Phone: (662) 874-5964
Fax: (662) 874-5176
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 13705 (TN)

Record details

NPI number1104593599
Entity typeIndividual (Type 1)
GenderMale
Credentials DPT
Sole proprietorNo
NPI enumeratedAugust 24, 2021
Last updated in NPPESFebruary 1, 2023
Certification dateFebruary 1, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Huling Physical Therapy Llc — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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