Gary Dwain Carr, MD

Primary specialty

Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X

License

10683 Issued in MS

Practice address

6858 Swinnea Rd BLDG 7
Southaven, MS 38671-9493

Phone

(662) 510-8400

Fax

(662) 510-8500

NPI assigned

Nov 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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

Interoperability endpoints

• 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.

• Region 12 Commission on Mental Health & Retardation Pine Belt Men

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Hattiesburg, MS
  • NPI 1982610572
  Medicare reassignment NPD
• Live Oaks Addiction Professionals

  • Addiction Medicine (Family Medicine) Physician
  • Southaven, MS
  • NPI 1619433943
  NPD Authorized official
• Region XII Commission

  • General Practice Physician
  • Laurel, MS
  • NPI 1467767988
  NPD
• Wesley Physician Services LLC

  • Family Medicine Physician
  • Hattiesburg, MS
  • NPI 1538200209
  NPD (past)

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695254400000",
    "number": "1093887945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 METHODIST BLVD STE 100",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021267",
            "telephone_number": "601-296-3151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6858 SWINNEA RD BLDG 7",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386719493",
            "telephone_number": "662-510-8400",
            "fax_number": "662-510-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARR",
        "first_name": "GARY",
        "middle_name": "DWAIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2023-09-21",
        "certification_date": "2023-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "MS",
            "license": "10683",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "10683",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00017378",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Caring Hands at Home NMC
• Carnahan Clinic PLLC
• Walter Earl Carnahan, DO
• Donnielle Carney, NP
• Julie J Carpenter, MD
• Jaqueline Tolleson Carter, LPC/MHSP
• Marlee Carter, SLP
• Rachel Shea Carter, PTA
• Abigail Yocasta Casey, LPC
• Ruth Ouzts Cash, PH.D., NCC, LPC

• Addiction Medicine (Family Medicine) Physician in Southaven, MS
• Providers in Southaven, MS by specialty
• Addiction Medicine (Family Medicine) Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2023; 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.