NPIMap

Individual provider Active NPI

Marshall Bynum, PA

  • Medical Physician Assistant
  • Hattiesburg, MS
National Provider Identifier
1174980213
Registry record updated Jan 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
3688 Veterans Memorial Dr
Suite 200
Hattiesburg, MS 39401-8246
Phone
(601) 554-7400
Fax
(601) 554-7499
NPI assigned
Jan 20, 2016
Last updated
Jan 20, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

3688 Veterans Memorial Dr
Suite 200
Hattiesburg, MS 39401-8246

Mailing address

3688 Veterans Memorial Dr
Suite 200
Hattiesburg, MS 39401-8246
Phone (601) 554-7400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160215001846 MS Practitioner - Physician Assistant 2567766306 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1215 Hwy 98 Byp
Columbia, MS 39429-3702
Phone (601) 554-7400

3688 Veterans Memorial Dr
Suite 200
Hattiesburg, MS 39401-8246
Phone (601) 554-7400

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
56.72 of 100Reported as individual
Quality
20.09
Promoting interoperability
53
Improvement activities
40
Cost
74.8

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Bone & Joint Specialists CurrentSince Feb 9, 2016 Accepting new patients

Locations

1215 Highway 98 Byp
Columbia, MS 39429
Phone (601) 268-5070

3688 Veterans Memorial Dr
Ste 200
Hattiesburg, MS 39401
Phone (601) 554-7451

1706 W 10th St
Laurel, MS 39440
Phone (601) 682-0455

Interoperability endpoints

  • Direct secure messaging: marshall.bynum.p1@direct.southernboneandjoint.nextgenshare.com

Organizations & group practices 2

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 7

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": "1453248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453248000000",
    "number": "1174980213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3688 VETERANS MEMORIAL DR",
            "address_2": "SUITE 200",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394018246",
            "telephone_number": "601-554-7400",
            "fax_number": "601-554-7499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3688 VETERANS MEMORIAL DR",
            "address_2": "SUITE 200",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394018246",
            "telephone_number": "601-554-7400",
            "fax_number": "601-554-7499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BYNUM",
        "first_name": "MARSHALL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-01-20",
        "last_updated": "2016-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

Verify at the official NPI Registry.