NPIMap

Individual provider Active NPI

Dirk H. Danielson, MD

  • Emergency Medicine Physician
  • Picayune, MS
National Provider Identifier
1104869353
Registry record updated Jul 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
13167 Issued in MS
Practice address
801Goodyear Blvd.
Picayune, MS 39466-3221
Phone
(601) 452-9690
NPI assigned
Jun 14, 2006
Last updated
Jul 6, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 13167 MS Primary

Addresses

Primary practice location

801Goodyear Blvd.
Picayune, MS 39466-3221

Mailing address

200 Corporate Blvd.
Suite 201
Lafayette, LA 70508
Phone (800) 893-9698

Other identifiers 3

IdentifierTypeStateIssuer
00125003MedicaidMS
P00388803OtherMSRAILROAD MCARE THRU IHS
P00806413OtherMSRRMCARE THRU HCCN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040617000409 MS Practitioner - Emergency Medicine 6406830397 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Mississippi School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jackson HB Medical Services LLCGroup PAC ID 6103273131, 50 clinicians
Hattiesburg HB Medical Services LLCGroup PAC ID 6507220167, 27 clinicians

Practice addresses (Care Compare)

1850 Chadwick Dr
Jackson, MS 39204-3404
Phone (601) 376-2832

5001 Hardy St
Hattiesburg, MS 39402-1308
Phone (601) 286-2090

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
42.86 of 100Reported as group
Quality
0
Improvement activities
40
Cost
74.29

Merit-based Incentive Payment System (MIPS)

Final score
60.83 of 100Reported as group
Quality
0
Improvement activities
40
Cost
76.94

Merit-based Incentive Payment System (MIPS)

Final score
73.84 of 100Reported as group
Quality
26.67
Improvement activities
40
Cost
80.57

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13167MSMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson HB Medical Services LLC Emergency Medicine CurrentSince Oct 15, 2023 Accepting new patients
Hattiesburg HB Medical Services LLC Emergency Medicine CurrentSince Jul 20, 2023 Accepting new patients
App of Mississippi Ed, LLC Emergency Medicine CurrentSince Oct 2, 2018 Accepting new patients
Natchez HB Medical Services LLC Emergency Medicine CurrentSince Jul 19, 2023 Accepting new patients
Mississippi Physicians LLP Emergency Medicine Current Accepting new patients
Mississippi Physicians LLP Emergency Medicine CurrentSince May 1, 2015 Accepting new patients
Paragon Contracting Services LLC Emergency Medicine Past Accepting new patients
Gulfport Emergency Physicians Emergency Medicine Past Accepting new patients
Acs Emergency Physicians PA Emergency Medicine Past Accepting new patients
Grandiflora Emergency Physicians Emergency Medicine Past Accepting new patients
Innovative Health Services LLC Emergency Medicine PastSince Jan 28, 2009 Accepting new patients
Memorial Hospital at Gulfport Emergency Medicine Past Accepting new patients

Locations

200 Corporate Blvd
Ste 201
Lafayette, LA 70508

150 Reynoir St
Biloxi, MS 39530
Phone (228) 284-2389

161 River Oaks Dr
Canton, MS 39046
Phone (601) 855-4000

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

1030 River Oaks Dr
Jackson, MS 39232
Phone (601) 376-2165

1225 N State St
Jackson, MS 39202
Phone (601) 292-4261

1850 Chadwick Dr
Jackson, MS 39204
Phone (601) 376-1000

54 Sgt Prentiss Dr
Natchez, MS 39120
Phone (601) 443-2100

Organizations & group practices 12

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 2

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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278374400000",
    "number": "1104869353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CORPORATE BLVD.",
            "address_2": "SUITE 201",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "70508",
            "telephone_number": "800-893-9698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801GOODYEAR BLVD.",
            "city": "PICAYUNE",
            "state": "MS",
            "postal_code": "394663221",
            "telephone_number": "601-452-9690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIELSON",
        "first_name": "DIRK",
        "middle_name": "H.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2010-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MS",
            "license": "13167",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00125003",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MCARE THRU IHS",
            "identifier": "P00388803",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMCARE THRU HCCN",
            "identifier": "P00806413",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Picayune, MS

Sources for this page

Verify at the official NPI Registry.