Organization Active NPI

Medical Arts Pediatric Clinic

  • Pediatrics Physician
  • Meridian, MS
National Provider Identifier
1124119862
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
MEDICAL ARTS PEDIATRIC CLINIC
Practice address
2024 15TH St
5TH Floor North
Meridian, MS 39301-4130
Phone
(601) 693-2777
Fax
(601) 482-8219
NPI assigned
Sep 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. William B Simmons, M.D.
Title
Partner
Phone
(601) 693-2777

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

2024 15TH St
5TH Floor North
Meridian, MS 39301-4130

Mailing address

2024 15TH St
5TH Floor North
Meridian, MS 39301-4130
Phone (601) 693-2777

Other identifiers 1

IdentifierTypeStateIssuer
09012505MedicaidMS

National Provider Directory

National Provider Directory

Locations

2024 15th St
Fl 5
Meridian, MS 39301
Phone (601) 553-6399

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124119862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2024 15TH ST",
            "address_2": "5TH FLOOR NORTH",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393014130",
            "telephone_number": "601-693-2777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2024 15TH ST",
            "address_2": "5TH FLOOR NORTH",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393014130",
            "telephone_number": "601-693-2777",
            "fax_number": "601-482-8219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL ARTS PEDIATRIC CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SIMMONS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "601-693-2777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09012505",
            "state": "MS"
        }
    ],
    "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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.