Individual provider Active NPI

Andrew Richard Hayslett

  • Pediatrics Physician
  • Jackson, MS
National Provider Identifier
1144631649
Registry record updated Nov 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
25144 Issued in MS
Practice address
2500 N. State St.
Ummc, Department of Pediatrics
Jackson, MS 39216
Phone
(601) 815-6211
Fax
(601) 815-8250
NPI assigned
May 19, 2014
Last updated
Nov 4, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2019

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 25144 MS Primary

Addresses

Primary practice location

2500 N. State St.
Ummc, Department of Pediatrics
Jackson, MS 39216

Mailing address

2500 N. State St.
Cbo - Suite 4200
Jackson, MS 39216-4500
Phone (601) 496-9794

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
I20171214001685 MS Practitioner - Pediatric Medicine 3173840766 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
University of Mississippi School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2500 N State St
Jackson, MS 39216-4500
Phone (601) 898-4404

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25144MSMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Oct 27, 2019 Accepting new patients
Memorial Hospital at Gulfport CurrentSince Apr 15, 2024 Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Dec 1, 2017 Accepting new patients
Memorial Hospital at Gulfport Current Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Dec 1, 2017 Accepting new patients
Memorial Hospital at Gulfport CurrentSince Apr 15, 2024 Accepting new patients
Memorial Hospital at Gulfport Past Accepting new patients

Locations

1340 Broad Ave
Ste 440
Gulfport, MS 39501
Phone (228) 867-4856

2500 N State St
Jackson, MS 39216
Phone (601) 815-4775

2500 N State St
Ste 4200
Jackson, MS 39216

20091 Pineville Rd
Long Beach, MS 39560
Phone (228) 868-3684

Interoperability endpoints

  • Direct secure messaging: ahayslett@direct.mhg.com

Organizations & group practices 7

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": "1400457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572825600000",
    "number": "1144631649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 N. STATE ST.",
            "address_2": "CBO - SUITE 4200",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-496-9794",
            "fax_number": "601-815-0434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N. STATE ST.",
            "address_2": "UMMC, DEPARTMENT OF PEDIATRICS",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39216",
            "telephone_number": "601-815-6211",
            "fax_number": "601-815-8250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYSLETT",
        "first_name": "ANDREW",
        "middle_name": "RICHARD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-19",
        "last_updated": "2019-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MS",
            "license": "25144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.