Organization Active NPI

Pathway Healthcare- Columbus, Ms LLC

  • Addiction Medicine (Family Medicine) Physician
  • Columbus, MS
National Provider Identifier
1245755990
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X
Legal business name
PATHWAY HEALTHCARE- COLUMBUS, MS LLC
Practice address
3600 Bluecutt Rd Ste 200
Columbus, MS 39705-1303
Phone
(731) 265-6025
Fax
(731) 265-6028
NPI assigned
Aug 3, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Authorized official

Name
Krystal Spencer
Title
Business Office Manager
Phone
(731) 265-6025

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QA0401X Primary

Addresses

Primary practice location

3600 Bluecutt Rd Ste 200
Columbus, MS 39705-1303

Mailing address

37 Sandstone Cir Ste 92
Jackson, TN 38305-3168
Phone (731) 265-6025

Other practice location 1

1 Medical Plaza Dr
Vicksburg, MS 39180-5187
Phone (601) 883-0264

National Provider Directory

National Provider Directory

Locations

3600 Bluecutt Rd
Ste 201
Columbus, MS 39705
Phone (662) 329-3973

1 Medical Plaza Dr
Vicksburg, MS 39180
Phone (601) 883-0264

NPI Registry JSON

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

{
    "created_epoch": "1501718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1245755990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 SANDSTONE CIR STE 92",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383053168",
            "telephone_number": "731-265-6025",
            "fax_number": "731-265-6028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 BLUECUTT RD STE 200",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "397051303",
            "telephone_number": "731-265-6025",
            "fax_number": "731-265-6028"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Medical Plaza Dr",
            "address_purpose": "LOCATION",
            "city": "Vicksburg",
            "state": "MS",
            "postal_code": "391805187",
            "country_code": "US",
            "telephone_number": "601-883-0264",
            "fax_number": "601-883-0266",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PATHWAY HEALTHCARE- COLUMBUS, MS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-03",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "SPENCER",
        "authorized_official_first_name": "KRYSTAL",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "731-265-6025"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.