Buddy Lee Eady, D.C.
Individual provider Active NPI Chiropractor · Forest, MS
NPI 1295821072 · NPPES record last updated Oct 29, 2010
Key facts
- NPI
- 1295821072
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 1032 (MS)
- Practice address
- 500 East 3Rd St.
Forest, MS 39074 - Phone
- (601) 469-3030
- Fax
- (601) 469-2522
- NPI assigned
- Oct 5, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
500 E 3Rd St
Forest, MS 39074-4224
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050720000996 | MS | Practitioner - Chiropractic | 5193752236 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1032 | MS | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eady Chiropractic, P.a. | Chiropractor | Current |
Accepting new patients |
Locations
500 E Third St
Forest, MS 39074
Phone (601) 469-3030
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 1032 | MS | Yes |
Addresses
Primary practice location
500 East 3Rd St.
Forest, MS 39074
Mailing address
3819 Tanglewood Rd
Lawrence, MS 39336
Phone (601) 469-3030
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00126310 | Medicaid | MS |
Other providers in Forest, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 29, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.