Michael W Fairbanks, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

1-066504 Issued in AL

Practice address

2490 Pass Rd
Biloxi, MS 39531-2838

Phone

(228) 207-9967

Fax

(228) 273-1532

NPI assigned

Aug 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ocean Springs Urgent CareGroup PAC ID 0244426195, 18 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Ocean Springs Urgent Care

  • Urgent Care Clinic/Center
  • Ocean Springs, MS
  • NPI 1871808022

  MS

  Medicare reassignment Care Compare group
• Maxem Health Urgent Care Diberville

  • Urgent Care Clinic/Center
  • Diberville, MS
  • NPI 1265991608

  MS

  Medicare reassignment NPD
• Orange Grove Urgent Care

  • Urgent Care Clinic/Center
  • Gulfport, MS
  • NPI 1831330661

  MS

  Medicare reassignment NPD
• Pascagoula Urgent Care

  • Urgent Care Clinic/Center
  • Pascagoula, MS
  • NPI 1235442872

  MS

  Medicare reassignment NPD
• Petal Urgent Care LLC

  • Urgent Care Clinic/Center
  • Petal, MS
  • NPI 1982908877

  MS

  Medicare reassignment NPD
• Picayune Urgent Care Clinic, LLC

  • Urgent Care Clinic/Center
  • Picayune, MS
  • NPI 1780723502

  MS

  Medicare reassignment NPD
• South Mississippi Urgent Care

  • Urgent Care Clinic/Center
  • Dlberville, MS
  • NPI 1750308250

  MS

  Medicare reassignment NPD
• Gulfport 49 Imaging, LLC

  • Radiology Clinic/Center
  • Gulfport, MS
  • NPI 1134702301
  NPD
• Edgewater Urgent Medical Care, LLC

  • Urgent Care Clinic/Center
  • Biloxi, MS
  • NPI 1730357666
  NPD (past)
• Picayune Family Practice Clinic, LLC

  • Primary Care Clinic/Center
  • Picayune, MS
  • NPI 1972771806
  NPD (past)
• Beaumont Emergency Medicine Associates PLLC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Beaumont, TX
  • NPI 1881716983
  NPD (past)
• Emergency Health Services Associates, P.a.

  • Emergency Medicine Physician
  • Beaumont, TX
  • NPI 1225088479
  NPD (past)

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466985600000",
    "number": "1215949896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7421 JOE FOUNTAIN RD",
            "city": "OCEAN SPRINGS",
            "state": "MS",
            "postal_code": "395649626",
            "telephone_number": "228-238-9149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2490 PASS RD",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395312838",
            "telephone_number": "228-207-9967",
            "fax_number": "228-273-1532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIRBANKS",
        "first_name": "MICHAEL",
        "middle_name": "W",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2016-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1-066504",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02672857",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "900279914",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONERS",
            "identifier": "1-066504",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "811413110",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHCS",
            "identifier": "900279914",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MS PHYSICIAN CARE NETWORK",
            "identifier": "900279914",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Exceed of Ms, LLC
• Eye Associates of the South
• Eye Associates of the South PLLC
• Clinton John Ezekiel, M.D.
• Pamela Sue Ezell, ATC, LAT
• Binesha Fairley, LCSW
• Stacy Denise Fairley, LMSW
• Family Medical Center, P.a. of Biloxi
• Sheena M Fanton, PT
• Ann Elizabeth Farash, M.D.

• All providers in Biloxi, MS
• Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.