Joseph Matthew Fairley Sr.

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

Practice address

1466 Kristen Dr
Jackson, MS 39211-2115

Phone

(601) 497-4757

NPI assigned

Dec 24, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1608768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608768000000",
    "number": "1144817115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1466 KRISTEN DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392112115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1466 KRISTEN DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392112115",
            "telephone_number": "601-497-4757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIRLEY",
        "first_name": "JOSEPH",
        "middle_name": "MATTHEW",
        "name_suffix": "Sr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-12-24",
        "last_updated": "2020-12-24",
        "certification_date": "2020-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "800718433",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "80078433",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Olivia Patch Facundus
• Abigail Kathryn Fagan
• Angela Fagan
• Byron W Fair, PT
• Logan D Fair, MD
• Faith & Hope Independent Living Health Services of Ms Inc.
• Faith and Hope Adult Daycare
• Faith Nemt LLC
• Faithful Hearts LLC
• Zahra Faizi, MD

• Non-emergency Medical Transport (VAN) in Jackson, MS
• Providers in Jackson, MS by specialty
• Non-emergency Medical Transport (VAN) in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 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.