Organization Active NPI

Nancy Dorman MD,PHD PLLC

  • Infectious Disease Physician
  • Flowood, MS
National Provider Identifier
1295999472
Registry record updated Jul 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
12674 Issued in MS
Legal business name
NANCY DORMAN MD,PHD PLLC
Practice address
1040 River Oaks Dr
Flowood, MS 39232-9530
Phone
(601) 933-5660
NPI assigned
Jul 16, 2008
Last updated
Jul 17, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2008

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

Authorized official

Name
Nicole Younkins
Title
CPC
Phone
(601) 944-1717

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 12674 MS Primary

Addresses

Primary practice location

1040 River Oaks Dr
Flowood, MS 39232-9530

Mailing address

PO Box 863
Jackson, MS 39205-0863

Other identifiers 1

IdentifierTypeStateIssuer
00018785MedicaidMS

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1216166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216252800000",
    "number": "1295999472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 863",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392050863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 RIVER OAKS DR",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329530",
            "telephone_number": "601-933-5660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NANCY DORMAN MD,PHD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-16",
        "last_updated": "2008-07-17",
        "status": "A",
        "authorized_official_last_name": "YOUNKINS",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "CPC",
        "authorized_official_telephone_number": "601-944-1717"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "MS",
            "license": "12674",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00018785",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flowood, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2008; 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.