Individual provider Active NPI

Donald E Netherland, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • McComb, MS
National Provider Identifier
1275601015
Registry record updated Jul 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
12566 Issued in MS
Practice address
300 Marion Ave
McComb, MS 39648-2754
Phone
(601) 249-1350
Fax
(601) 249-1339
NPI assigned
Dec 1, 2006
Last updated
Jul 11, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 12566 MS Primary

Addresses

Primary practice location

300 Marion Ave
McComb, MS 39648-2754

Mailing address

PO Box 490
McComb, MS 39649-0490
Phone (601) 249-1350

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, LA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070322000423 MS Practitioner - Vascular SurgeryPractitioner - Thoracic Surgery 5092609297 Reassigns benefits to 1 organization
I20170327001368 LA Practitioner - Thoracic SurgeryPractitioner - Cardiac Surgery 5092609297 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
University of Tennessee, HSC, College of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kings Daughters Medical CenterGroup PAC ID 3072575539, 75 clinicians
Paeon Health Services IncGroup PAC ID 1153697727, 55 clinicians

Practice addresses (Care Compare)

427 Hwy 51 N
Brookhaven, MS 39601-2350
Phone (601) 833-6011

8166 Main St
Houma, LA 70360-3404
Phone (985) 873-4751

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary artery bypass graft (CABG)1-10
Leg revascularization (restoring blood flow)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Kings Daughters Medical Center Current Accepting new patients
Terrebonne Parish Hospital Service District #1 Current Accepting new patients
King's Daughters Medical Center CurrentSince Aug 9, 2019 Accepting new patients
King's Daughters Medical Center CurrentSince Aug 9, 2019 Accepting new patients
Cardiothoracic & Vascular Surgery, PA Thoracic Surgery (Cardiothoracic Vascular Surgery) PastSince Dec 1, 2000 Accepting new patients
Southwest Mississippi Regional Medical Center Past Accepting new patients

Locations

8166 Main St
Houma, LA 70360
Phone (800) 456-9121

855 Belanger St
Ste 101
Houma, LA 70360
Phone (985) 850-6222

427 Highway 51 N
Brookhaven, MS 39601
Phone (601) 833-6011

Organizations & group practices 7

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 1

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": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373500800000",
    "number": "1275601015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 490",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396490490",
            "telephone_number": "601-249-1350",
            "fax_number": "601-249-1339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MARION AVE",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396482754",
            "telephone_number": "601-249-1350",
            "fax_number": "601-249-1339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NETHERLAND",
        "first_name": "DONALD",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-01",
        "last_updated": "2013-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "MS",
            "license": "12566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McComb, MS

Sources for this page

Verify at the official NPI Registry.