Lowry C Stanford Jr., MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

17927 Issued in MS

Practice address

39 Franklin Rd
Ste 220
Hattiesburg, MS 39402-1588

Phone

(601) 296-3050

NPI assigned

Apr 19, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lowry.stanford.1@1930.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/1930/brand/2/csg/102/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Wesley Physician Services LLC

  • Family Medicine Physician
  • Hattiesburg, MS
  • NPI 1538200209

  MS, Pediatrics

  Medicare reassignment NPD
• Wesley Health System LLC

  • General Acute Care Hospital
  • Hattiesburg, MS
  • NPI 1841241841
  NPD (past)

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598486400000",
    "number": "1013972306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 FRANKLIN RD",
            "address_2": "STE 220",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021588",
            "telephone_number": "601-296-3050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 FRANKLIN RD",
            "address_2": "STE 220",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021588",
            "telephone_number": "601-296-3050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANFORD",
        "first_name": "LOWRY",
        "middle_name": "C",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2020-08-27",
        "certification_date": "2020-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MS",
            "license": "17927",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09016137",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08539218",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lowry.stanford.1@1930.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "39 Franklin Rd",
            "address_2": "Ste 220",
            "city": "Hattiesburg",
            "state": "MS",
            "country_code": "US",
            "postal_code": "394021588",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• St Michaels Urgent Care of Hattiesburg
• Karol Scott St. Louis, RPH
• Amanda Elizabeth Stafford
• Reagan Aldridge Standland, SLP
• Tyler Standland
• Melissa Stanford, CNP
• Brankica Stanisic, MD
• Amanda Stanley
• Joel Chadwick Stanley, D.M.D.
• Tracy Faler Stanley, D.M.D. M.S.

• All providers in Hattiesburg, MS
• Pediatrics Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.