NPIMap

Organization Active NPI

Pearl Family Clinic

  • Family Medicine Physician
  • Pearl, MS
National Provider Identifier
1316285703
Registry record updated Jan 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PEARL FAMILY CLINIC
Practice address
187 Doctors Dr
Pearl, MS 39208-4042
Phone
(601) 939-8921
NPI assigned
Jan 21, 2013
Last updated
Jan 21, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2013

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

Authorized official

Name
William Krooss II, MDNPI 1588653901
Title
Managing Partner
Phone
(601) 932-3191

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

187 Doctors Dr
Pearl, MS 39208-4042

Mailing address

PO Box 320609
Flowood, MS 39232-0609
Phone (601) 932-3191

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1358726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358726400000",
    "number": "1316285703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 320609",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392320609",
            "telephone_number": "601-932-3191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "187 DOCTORS DR",
            "city": "PEARL",
            "state": "MS",
            "postal_code": "392084042",
            "telephone_number": "601-939-8921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEARL FAMILY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-21",
        "last_updated": "2013-01-21",
        "status": "A",
        "authorized_official_last_name": "KROOSS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "601-932-3191",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pearl, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2013; 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.