Individual provider Active NPI

Taylor Joseph Mabry, MD

  • Allergy & Immunology Physician
  • Jackson, MS
National Provider Identifier
1154819415
Registry record updated Jan 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
27668 Issued in MS
Practice address
1040 River Oaks Dr Ste 100
Jackson, MS 39232-9531
Phone
(601) 401-6675
Fax
(769) 207-6215
NPI assigned
Apr 23, 2018
Last updated
Jan 15, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X 27668 MS Primary

Addresses

Primary practice location

1040 River Oaks Dr Ste 100
Jackson, MS 39232-9531

Mailing address

415 S 28TH Ave
Hattiesburg, MS 39401-7246
Phone (601) 264-6000

Other practice location 1

2500 N State St
Jackson, MS 39216-4500
Phone (601) 984-5604

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240503000450 MS Practitioner - Allergy/ImmunologyPractitioner - Internal Medicine 3274973540 Reassigns benefits to 2 organizations
I20260407001154 DC Practitioner - Mental Health Counselor 3274973540 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/ImmunologyAlso: Internal Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hattiesburg Clinic PAGroup PAC ID 5193706794, 525 clinicians

Practice addresses (Care Compare)

415 S 28TH Ave
Hattiesburg, MS 39401-7246
Phone (601) 264-6000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
27668MSMDAllergy & Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
State of Mississippi - University of Mississippi Medical Center Current Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Sep 13, 2024 Accepting new patients
Hattiesburg Clinic PA CurrentSince Mar 25, 2024 Accepting new patients
Hattiesburg Clinic, PA CurrentSince Mar 25, 2024 Accepting new patients
State of Mississippi-University of Mississippi Medical Center CurrentSince Sep 13, 2024 Accepting new patients

Locations

294 E Layfair Dr
Flowood, MS 39232
Phone (601) 414-6520

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

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

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1524441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768435200000",
    "number": "1154819415",
    "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": "601-264-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 RIVER OAKS DR STE 100",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392329531",
            "telephone_number": "601-401-6675",
            "fax_number": "769-207-6215"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 N State St",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "392164500",
            "country_code": "US",
            "telephone_number": "601-984-5604",
            "fax_number": "601-984-6665",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MABRY",
        "first_name": "TAYLOR",
        "middle_name": "JOSEPH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-23",
        "last_updated": "2026-01-15",
        "certification_date": "2026-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "MS",
            "license": "27668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.