Healthy Path Doc, LLC

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

Legal business name

HEALTHY PATH DOC, LLC

Practice address

5358 Carolwood Dr
Jackson, MS 39211-4267

Phone

(601) 405-4163

NPI assigned

May 4, 2023

Last updated

May 4, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Lafarra Demetric Young-Gaylor, MDNPI 1700034451

Title

Manager

Phone

(601) 405-4163

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lafarra Demetric Young-Gaylor, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Jackson, MS
  • NPI 1700034451
  NPD Authorized official

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

{
    "created_epoch": "1683158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683158400000",
    "number": "1174212203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5358 CAROLWOOD DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392114267",
            "telephone_number": "601-405-4163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5358 CAROLWOOD DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392114267",
            "telephone_number": "601-405-4163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHY PATH DOC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-04",
        "last_updated": "2023-05-04",
        "certification_date": "2023-05-04",
        "status": "A",
        "authorized_official_last_name": "YOUNG-GAYLOR",
        "authorized_official_first_name": "LAFARRA",
        "authorized_official_middle_name": "DEMETRIC",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "601-405-4163",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Anatomic Pathology & Clinical Pathology Physician in Jackson, MS
• Providers in Jackson, MS by specialty
• Anatomic Pathology & Clinical Pathology Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2023; 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.