Individual provider Active NPI

William Robert Justice Jr., M.D.

  • Pediatrics Physician
  • Meridian, MS
National Provider Identifier
1124480033
Registry record updated Nov 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
25857 Issued in MS
Practice address
1600 22ND Avenue
Medical Towers 3, Third Floor, Suite B
Meridian, MS 39301
Phone
(601) 703-8370
Fax
(601) 703-8397
NPI assigned
Mar 22, 2016
Last updated
Nov 6, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2024

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 25857 MS Primary

Addresses

Primary practice location

1600 22ND Avenue
Medical Towers 3, Third Floor, Suite B
Meridian, MS 39301

Mailing address

PO Box 749215
Atlanta, GA 30374-9215
Phone (901) 226-3186

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
I20241030001262 MS Practitioner - Pediatric Medicine 5496040941 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25857MSMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anderson Regional Medical Center CurrentSince Aug 16, 2024 Accepting new patients
Anderson Regional Medical Center CurrentSince Aug 16, 2024 Accepting new patients
Anderson Regional Medical Center Current Accepting new patients
Anderson Physician Alliance, Inc. PastSince Nov 10, 2024 Accepting new patients
Anderson Regional Medical Center Past Accepting new patients

Locations

1102 Constitution Ave
Meridian, MS 39301
Phone (601) 693-2511

1600 22nd Ave
#3
Meridian, MS 39301
Phone (601) 693-1055

2124 14th St
Meridian, MS 39301
Phone (601) 483-8811

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 5

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": "1458604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1124480033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 749215",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303749215",
            "telephone_number": "901-226-3186",
            "fax_number": "901-226-3160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 22ND AVENUE",
            "address_2": "MEDICAL TOWERS 3, THIRD FLOOR, SUITE B",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "39301",
            "telephone_number": "601-703-8370",
            "fax_number": "601-703-8397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUSTICE",
        "first_name": "WILLIAM",
        "middle_name": "ROBERT",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-22",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MS",
            "license": "25857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, MS

Sources for this page

Verify at the official NPI Registry.