Jonathan H.S. Rayburn, MD

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

License

27015 Issued in MS

Practice address

1 Lincoln Pkwy Ste 103
Hattiesburg, MS 39402-3261

Phone

(601) 261-1600

Fax

(601) 264-5133

NPI assigned

Apr 3, 2014

Last updated

Jul 8, 2020By the provider in NPPES

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 1

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

Specialty

Pain Management

Education

University of Mississippi School of Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hattiesburg Clinic PAGroup PAC ID 5193706794, 525 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• South Central Reg Med Ctr Hospital, Laurel, MS, CCN 250058
• Forrest General Hospital Hospital, Hattiesburg, MS, CCN 250078

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jrayburn91193@directpatientrecord.com

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.

• Hattiesburg Clinic PA

  • Multi-Specialty Clinic/Center
  • Hattiesburg, MS
  • NPI 1740213446
  Medicare reassignment Care Compare group NPD
• Hattiesburg Clinic, PA

  dba Flowood Primary Care

  • Primary Care Clinic/Center
  • Flowood, MS
  • NPI 1912600354
  NPD
• Hattiesburg Clinic, PA

  dba Laurel Dialysis Unit

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Laurel, MS
  • NPI 1245263540
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Forrest County General Hospital

  • General Acute Care Hospital
  • Hattiesburg, MS
  • NPI 1225041809
  Care Compare affiliation
• South Central Regional Medical Center

  • General Acute Care Hospital
  • Laurel, MS
  • NPI 1619973542
  Care Compare affiliation

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

{
    "created_epoch": "1396483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594166400000",
    "number": "1033537212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 S 28TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017246",
            "telephone_number": "601-261-1600",
            "fax_number": "601-579-5240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 LINCOLN PKWY STE 103",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394023261",
            "telephone_number": "601-261-1600",
            "fax_number": "601-264-5133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYBURN",
        "first_name": "JONATHAN",
        "middle_name": "H.S.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-03",
        "last_updated": "2020-07-08",
        "certification_date": "2020-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "MS",
            "license": "27015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08820253",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jrayburn91193@directpatientrecord.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1 Lincoln Pkwy Ste 103",
            "city": "Hattiesburg",
            "state": "MS",
            "country_code": "US",
            "postal_code": "394023261",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Taylor Marie Rawls, PA-C
• Courtney Jackson Ray, LPC
• Stephanie Ray, FNP
• Michong Rayborn, CRNA
• Erin Jones Rayburn, DMD
• Raye Medical Management
• Billy Gene Ready Jr., PHD, MA
• Real Life Christian Counseling Center
• Rebecca R Duff, PLLC (Duff Dermatology)
• Adhvith Reddivari, DO

• Pain Medicine (Anesthesiology) Physician in Hattiesburg, MS
• Providers in Hattiesburg, MS by specialty
• Pain Medicine (Anesthesiology) Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.