Individual provider Active NPI

Gregory A Parvin, MD

  • Pediatrics Physician
  • Hattiesburg, MS
National Provider Identifier
1154346559
Registry record updated Jul 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
15853 Issued in MS
Practice address
101 Medical Park
Hattiesburg, MS 39401
Phone
(601) 579-3000
Fax
(601) 579-5240
NPI assigned
Jul 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2020

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 15853 MS Primary

Addresses

Primary practice location

101 Medical Park
Hattiesburg, MS 39401

Mailing address

415 S 28TH Ave
Hattiesburg, MS 39401-7246
Phone (601) 268-3735

Other identifiers 3

IdentifierTypeStateIssuer
00119307MedicaidMS
1559053OtherMSAMERICAN ADMIN GROUP
1739669OtherLALA MEDICAID

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dparvin1958@directpatientrecord.com Health Information Exchange (HIE)

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
I20080129000133 MS Practitioner - Pediatric Medicine 7315029402 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hattiesburg Clinic PA CurrentSince Jan 9, 2010 Accepting new patients
Hattiesburg Clinic, PA CurrentSince Jan 9, 2010 Accepting new patients
Hattiesburg Clinic, PA Past Accepting new patients
Forrest County General Hospital Past Accepting new patients

Locations

415 S 28th Ave
Hattiesburg, MS 39401
Phone (601) 261-3606

101 Medical Park
Hattiesburg, MS 39401
Phone (601) 268-3735

Interoperability endpoints

  • Direct secure messaging: dparvin1958@directpatientrecord.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594684800000",
    "number": "1154346559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 S 28TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017246",
            "telephone_number": "601-268-3735",
            "fax_number": "601-579-5240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MEDICAL PARK",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "39401",
            "telephone_number": "601-579-3000",
            "fax_number": "601-579-5240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARVIN",
        "first_name": "GREGORY",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2020-07-14",
        "certification_date": "2020-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MS",
            "license": "15853",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00119307",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN ADMIN GROUP",
            "identifier": "1559053",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LA MEDICAID",
            "identifier": "1739669",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dparvin1958@directpatientrecord.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "101 Medical Park",
            "city": "Hattiesburg",
            "state": "MS",
            "country_code": "US",
            "postal_code": "39401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

Verify at the official NPI Registry.