Active NPI
Joel G Payne Jr., MD
- Gynecology Physician
- Flowood, MS
National Provider Identifier
1003959818
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gynecology Physician
- License
- 06758
- Practice address
- 291 E Layfair Dr
Flowood, MS 39232-9527 - Phone
- (601) 936-9190
- Fax
- (601) 932-6714
- NPI assigned
- Feb 14, 2007
- Last updated
- Apr 20, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gynecology Physician | 207VG0400X | 06758 | MS | Primary |
Addresses
Primary practice location
291 E Layfair Dr
Flowood, MS 39232-9527
Mailing address
291 E Layfair Dr
Flowood, MS 39232-9527
Phone (601) 936-9190
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00119440 | Medicaid | MS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 06758 | MS | MD | Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jackson Healthcare for Women PA | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Obstetrics & Gynecology Physician
- Jackson, MS
- NPI 1902941768
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171411200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1303257600000",
"number": "1003959818",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "291 E LAYFAIR DR",
"city": "FLOWOOD",
"state": "MS",
"postal_code": "392329527",
"telephone_number": "601-936-9190",
"fax_number": "601-932-6714"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "291 E LAYFAIR DR",
"city": "FLOWOOD",
"state": "MS",
"postal_code": "392329527",
"telephone_number": "601-936-9190",
"fax_number": "601-932-6714"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAYNE",
"first_name": "JOEL",
"middle_name": "G",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-14",
"last_updated": "2011-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "207VG0400X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Gynecology",
"state": "MS",
"license": "06758",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00119440",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Flowood, MS
- Patriot Healthcare of Mississippi, LLC (PHC of MS Jackson)
- Taylor Patterson Patterson Geddie, M.D.
- Consuelo Patterson, NP
- Nekeitra Patterson, MT
- George E Patton Jr., M.D.
- Latrinia Danielle Payne, PMHNP-BC
- Taylor Michelle Pearson, PTA
- Pediatric Pathways Nursing Services, LLC
- Caroline Douglass Peeples, NP
- John Peeples
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.