NPIMap

Individual provider Active NPI

Desmond Wayne Hoda, D.C.

  • Chiropractor
  • Diamondhead, MS
National Provider Identifier
1194896902
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
887 Issued in MS
Practice address
4308 Park Ten Dr
Diamondhead, MS 39525-3222
Phone
(228) 255-5328
Fax
(228) 255-0026
NPI assigned
Nov 13, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 887 MS Primary

Addresses

Primary practice location

4308 Park Ten Dr
Diamondhead, MS 39525-3222

Mailing address

4308 Park Ten Dr
P.O. Box 6188
Diamondhead, MS 39525-3222
Phone (228) 255-5328

Other identifiers 1

IdentifierTypeStateIssuer
00115761MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080731000467 MS Practitioner - Chiropractic 9638243108 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4308 Park Ten Dr
Diamondhead, MS 39525-3222
Phone (228) 255-5328

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
887MSMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
D and F Inc Chiropractor CurrentSince Jan 13, 1994 Accepting new patients
Professional Rehabilitation Services Chiropractor Past Accepting new patients

Locations

4308 Park Ten Dr
Diamondhead, MS 39525
Phone (228) 255-5328

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 60

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

View all 60

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194896902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4308 PARK TEN DR",
            "address_2": "P.O. BOX 6188",
            "city": "DIAMONDHEAD",
            "state": "MS",
            "postal_code": "395253222",
            "telephone_number": "228-255-5328",
            "fax_number": "228-255-0026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4308 PARK TEN DR",
            "city": "DIAMONDHEAD",
            "state": "MS",
            "postal_code": "395253222",
            "telephone_number": "228-255-5328",
            "fax_number": "228-255-0026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HODA",
        "first_name": "DESMOND",
        "middle_name": "WAYNE",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MS",
            "license": "887",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00115761",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Diamondhead, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.