Active NPI
Jan Parr Boggs, PH.D.
- Psychologist
- Meridian, MS
National Provider Identifier
1285856112
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 25-335
- Practice address
- 1508 37TH Avenue
Meridian, MS 39307 - Phone
- (601) 482-4285
- Fax
- (601) 482-7972
- NPI assigned
- May 2, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 25-335 | MS | Primary |
Addresses
Primary practice location
1508 37TH Avenue
Meridian, MS 39307
Mailing address
P O Box 4093
Meridian, MS 39304-4093
Phone (601) 482-4285
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00015202 | Medicaid | MS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25-335 | MS | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1285856112",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P O BOX 4093",
"city": "MERIDIAN",
"state": "MS",
"postal_code": "393044093",
"telephone_number": "601-482-4285",
"fax_number": "601-482-7972"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1508 37TH AVENUE",
"city": "MERIDIAN",
"state": "MS",
"postal_code": "39307",
"telephone_number": "601-482-4285",
"fax_number": "601-482-7972"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOGGS",
"first_name": "JAN",
"middle_name": "PARR",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MS",
"license": "25-335",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00015202",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Meridian, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.