NPIMap

Organization Active NPI

Ridgeland Family Medical Ctr

  • Family Medicine Physician
  • Ridgeland, MS
National Provider Identifier
1285818005
Registry record updated Dec 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
12039 Issued in MS
Legal business name
RIDGELAND FAMILY MEDICAL CTR
Practice address
305 Highway 51
Ridgeland, MS 39157-3428
Phone
(601) 856-9980
Fax
(601) 856-9994
NPI assigned
Dec 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2011

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

Authorized official

Name
Carolyn Durr
Title
Office Manager
Phone
(601) 856-9980

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X 10806 MS
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X 12039 MS Primary
Clinic/Center 261Q00000X 12039 MS

Addresses

Primary practice location

305 Highway 51
Ridgeland, MS 39157-3428

Mailing address

305 Highway 51
Ridgeland, MS 39157-3428
Phone (601) 856-9980

Other identifiers 1

IdentifierTypeStateIssuer
CB6301OtherMSRAILROAD MEDICARE

National Provider Directory

National Provider Directory

Locations

305 Highway 51
Ridgeland, MS 39157
Phone (601) 856-7994

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1198800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325116800000",
    "number": "1285818005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 HIGHWAY 51",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391573428",
            "telephone_number": "601-856-9980",
            "fax_number": "601-856-9994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 HIGHWAY 51",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391573428",
            "telephone_number": "601-856-9980",
            "fax_number": "601-856-9994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIDGELAND FAMILY MEDICAL CTR",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-28",
        "last_updated": "2011-12-29",
        "status": "A",
        "authorized_official_last_name": "DURR",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "601-856-9980"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "10806",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "12039",
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MS",
            "license": "12039",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CB6301",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgeland, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2011; 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.