Kenneth Staggs Jr., MD

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

14732 Issued in MS

Practice address

1001 14TH St
Meridian, MS 39301-4458

Phone

(601) 482-9224

Fax

(601) 482-9223

NPI assigned

Sep 9, 2005

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

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

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.

• Southern Pain Associates, PLLC

  • Pain Medicine (Anesthesiology) Physician
  • Meridian, MS
  • NPI 1093709958
  Medicare reassignment NPD
• Total Pain Care LLC

  • Ambulatory Surgical Clinic/Center
  • Meridian, MS
  • NPI 1063445542
  NPD (past) Authorized official

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

{
    "created_epoch": "1126224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548633600000",
    "number": "1043204654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 14TH ST",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393014458",
            "telephone_number": "601-482-9224",
            "fax_number": "601-482-9223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 14TH ST",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393014458",
            "telephone_number": "601-482-9224",
            "fax_number": "601-482-9223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAGGS",
        "first_name": "KENNETH",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-09",
        "last_updated": "2019-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "MS",
            "license": "14732",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00116542",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Betty Spells
• Fred Douglas Spencer Jr.
• Casey Springer
• St. Anthony's Hospice, LLC
• Shelley R St. Germain, CRNA
• Shanice Stancil
• Stand Upright Equipment
• Stanley a. Wade, Jr., MD, PLLC
• Eddie S. Starnes, M.D.
• Susan S. Staton Johnson, SLP

• Interventional Pain Medicine Physician in Meridian, MS
• Providers in Meridian, MS by specialty
• Interventional Pain Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2019; 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.