Individual provider Active NPI

Justin M. Lay, D.O.

  • Pediatrics Physician
  • Madison, MS
National Provider Identifier
1093109316
Registry record updated Sep 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
25783 Issued in MS
Practice address
161 Montgomery St Ste D
Madison, MS 39110-1118
Phone
(769) 300-5200
Fax
(601) 623-4300
NPI assigned
Mar 25, 2015
Last updated
Sep 3, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 25783 MS Primary

Addresses

Primary practice location

161 Montgomery St Ste D
Madison, MS 39110-1118

Mailing address

161 Montgomery St Ste D
Madison, MS 39110-1118
Phone (769) 300-5220

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
I20150901002963 MS Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 1557677861

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25783MSMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pioneer Pediatrics, LLC Pediatrics Current Accepting new patients
Children's Medical Group, P.a. Pediatrics Current Accepting new patients

Locations

1867 Crane Ridge Dr
Ste 101B
Jackson, MS 39216
Phone (601) 362-8776

161 Montgomery St
Ste D
Madison, MS 39110
Phone (769) 300-5200

7726 Old Canton Rd
Madison, MS 39110
Phone (601) 856-5105

Interoperability endpoints

  • Direct secure messaging: justin.lay@924634546831364.direct.elationemr.com
  • Direct secure messaging: justinlay@cmgpa.allscriptsdirect.net

Organizations & group practices 2

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": "1427241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756857600000",
    "number": "1093109316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 MONTGOMERY ST STE D",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391101118",
            "telephone_number": "769-300-5220",
            "fax_number": "601-623-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 MONTGOMERY ST STE D",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391101118",
            "telephone_number": "769-300-5200",
            "fax_number": "601-623-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAY",
        "first_name": "JUSTIN",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-25",
        "last_updated": "2025-09-03",
        "certification_date": "2025-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MS",
            "license": "25783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, MS

Sources for this page

Verify at the official NPI Registry.