Individual provider Active NPI

Alex Gauthier

  • Internal Medicine Physician
  • Hattiesburg, MS
National Provider Identifier
1053773267
Registry record updated Apr 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Practice address
5001 Hardy St
Hattiesburg, MS 39402-1308
Phone
(601) 268-8000
NPI assigned
Mar 26, 2016
Last updated
Apr 14, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0 MS Primary

Addresses

Primary practice location

5001 Hardy St
Hattiesburg, MS 39402-1308

Mailing address

5001 Hardy St
Hattiesburg, MS 39402-1308
Phone (601) 268-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20191121002370 KY Practitioner - Internal Medicine 1254627607 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
William Carey University College of Osteopathic Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kentucky Hospitalist Group PLLCGroup PAC ID 0345656377, 10 clinicians

Practice addresses (Care Compare)

175 Hospital Dr
Winchester, KY 40391-9591
Phone (859) 901-0012

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Clark Regional Physician Practices, LLC Internal Medicine CurrentSince Sep 26, 2019 Accepting new patients
Kentucky Hospitalist Group, PLLC CurrentSince Apr 1, 2021 Accepting new patients
Clark Regional Physician Practices LLC CurrentSince Sep 26, 2019 Accepting new patients
Kentucky Hospital, LLC Past Accepting new patients

Locations

175 Hospital Dr
Winchester, KY 40391
Phone (859) 745-3500

225 Hospital Dr
Ste 200A
Winchester, KY 40391
Phone (859) 737-6480

330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780

Interoperability endpoints

  • Direct secure messaging: jqe7577@yourcarecommunity.org

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1458950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492128000000",
    "number": "1053773267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 HARDY ST",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021308",
            "telephone_number": "601-268-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5001 HARDY ST",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021308",
            "telephone_number": "601-268-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAUTHIER",
        "first_name": "ALEX",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-03-26",
        "last_updated": "2017-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "0",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

Verify at the official NPI Registry.