NPIMap

Organization Active NPI

Gregory a. Auzenne MD, PA

  • Pain Medicine (Anesthesiology) Physician
  • Meridian, MS
National Provider Identifier
1104374750
Registry record updated Mar 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
20220 Issued in MS
Legal business name
GREGORY A. AUZENNE MD, PA
Practice address
4803 29TH Ave Ste a
Meridian, MS 39305-2675
Phone
(601) 286-5477
Fax
(601) 286-5425
NPI assigned
Sep 12, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2023

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

Authorized official

Name
Dr. Gregory A Auzenne, M.D.NPI 1558421651
Title
President
Phone
(601) 286-5477

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LH0002X 20220 MS
Pain Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LP2900X 20220 MS Primary

Addresses

Primary practice location

4803 29TH Ave Ste a
Meridian, MS 39305-2675

Mailing address

P O Box 649107
Dallas, TX 75264
Phone (601) 286-5477

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170214001618 MS Part B Supplier - Clinic/Group Practice 1658654850 Receives reassigned benefits from 4 practitioners
Practice locations: Meridian, MS; Choctaw, MS

National Provider Directory

National Provider Directory

Locations

322 Highway 80 E
Ste D
Clinton, MS 39056
Phone (318) 791-3765

2340 N Hills St
Meridian, MS 39305

4803 29th Ave
Ste A
Meridian, MS 39305
Phone (601) 286-5477

1106 Central Dr
#1
Philadelphia, MS 39350
Phone (601) 650-9664

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1473638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679011200000",
    "number": "1104374750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 649107",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75264",
            "telephone_number": "601-286-5477",
            "fax_number": "601-286-5825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4803 29TH AVE STE A",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393052675",
            "telephone_number": "601-286-5477",
            "fax_number": "601-286-5425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREGORY A. AUZENNE MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-12",
        "last_updated": "2023-03-17",
        "certification_date": "2023-03-16",
        "status": "A",
        "authorized_official_last_name": "AUZENNE",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "601-286-5477",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207LH0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Hospice and Palliative Medicine",
            "state": "MS",
            "license": "20220",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "MS",
            "license": "20220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.