Individual provider Active NPI

John C Adams, MD

  • Family Medicine Physician
  • Pontotoc, MS
National Provider Identifier
1013026970
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
10235 Issued in MS
Practice address
353 Highway 15 N
Pontotoc, MS 38863-1103
Phone
(662) 490-1985
NPI assigned
Aug 30, 2006
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromusculoskeletal Medicine & OMM Physician 204D00000X 10235 MS
Family Medicine Physician 207Q00000X 10235 MS Primary

Addresses

Primary practice location

353 Highway 15 N
Pontotoc, MS 38863-1103

Mailing address

PO Box 497
Augusta, AR 72006-0497
Phone (870) 347-2534

Other practice location 1

1423 Palmetto Rd
Verona, MS 38879
Phone (662) 566-5593

Other identifiers 2

IdentifierTypeStateIssuer
0017133MedicaidMS
00017133MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040129000298 MS Practitioner - Family PracticePractitioner - Addiction Medicine 0941103709 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Family Health Center Inc CurrentSince Nov 1, 2018 Accepting new patients
Coastal Family Health Center, Inc CurrentSince Nov 1, 2018 Accepting new patients
Coastal Family Health Center, Inc Current Accepting new patients
Tishomingo Health Services, Inc. Past Accepting new patients
John W. White, Jr., MD, PA Past Accepting new patients

Locations

1046 Division St
Biloxi, MS 39530
Phone (225) 374-2494

4770 Amoco Dr
Moss Point, MS 39563
Phone (228) 474-9511

Organizations & group practices 5

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1013026970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 497",
            "city": "AUGUSTA",
            "state": "AR",
            "postal_code": "720060497",
            "telephone_number": "870-347-2534",
            "fax_number": "870-347-2023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "353 HIGHWAY 15 N",
            "city": "PONTOTOC",
            "state": "MS",
            "postal_code": "388631103",
            "telephone_number": "662-490-1985"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1423 Palmetto Rd",
            "address_purpose": "LOCATION",
            "city": "Verona",
            "state": "MS",
            "postal_code": "38879",
            "country_code": "US",
            "telephone_number": "662-566-5593",
            "fax_number": "662-566-4419",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ADAMS",
        "first_name": "JOHN",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "MS",
            "license": "10235",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "10235",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0017133",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00017133",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pontotoc, MS

Sources for this page

Verify at the official NPI Registry.