NPIMap

Individual provider Active NPI

Terry L. Bang, M.D.

  • Pediatrics Physician
  • Laurel, MS
National Provider Identifier
1316359789
Registry record updated Jan 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
24870 Issued in MS
Practice address
1002 Jefferson St.
Suite 200
Laurel, MS 39440-4306
Phone
(601) 649-3520
Fax
(601) 649-7899
NPI assigned
May 20, 2014
Last updated
Jan 6, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X 24870 MS Primary

Addresses

Primary practice location

1002 Jefferson St.
Suite 200
Laurel, MS 39440-4306

Mailing address

PO Box 247
Laurel, MS 39441-0247
Phone (601) 399-6169

Other practice location 1

2500 N State St
Jackson, MS 39216-4500
Phone (601) 984-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170802002928 TX Practitioner - Pediatric Medicine 2466776232 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
24870MSMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Employee Assistance Program Inc CurrentSince Dec 1, 2024 Accepting new patients
Regional Employee Assistance Program Inc CurrentSince Dec 1, 2024 Accepting new patients
South Central Clinics, Inc CurrentSince Jan 12, 2020 Accepting new patients
Regional Employee Assistance Program Inc Pediatrics Current Accepting new patients
Navarro Hospital LP Current Accepting new patients
Navarro Hospital LP Pediatrics CurrentSince Dec 1, 2024 Accepting new patients
Utmb Faculty Group Practice Pediatrics CurrentSince Jul 6, 2017 Accepting new patients
South Central Clinics, Inc PastSince Jan 12, 2020 Accepting new patients
Navarro Hospital LP Past Accepting new patients
Navarro Hospital LP Past Accepting new patients

Locations

234 S 12th Ave
Laurel, MS 39440
Phone (601) 426-4745

301 Hospital Dr
#150
Corsicana, TX 75110
Phone (903) 641-4800

301 Hospital Dr
Ste 150
Corsicana, TX 75110
Phone (903) 641-4800

3201 W State Highway 22
Corsicana, TX 75110
Phone (903) 654-6800

301 University Blvd
Galveston, TX 77555
Phone (409) 747-1883

Interoperability endpoints

  • Direct secure messaging: terry.bang.1@1902.direct.athenahealth.com
  • Direct secure messaging: terry.bang@direct.scrmc.com

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1400544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578268800000",
    "number": "1316359789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 247",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394410247",
            "telephone_number": "601-399-6169",
            "fax_number": "601-399-6281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 JEFFERSON ST.",
            "address_2": "SUITE 200",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394404306",
            "telephone_number": "601-649-3520",
            "fax_number": "601-649-7899"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 N State St",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "392164500",
            "country_code": "US",
            "telephone_number": "601-984-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BANG",
        "first_name": "TERRY",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-20",
        "last_updated": "2020-01-06",
        "certification_date": "2020-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MS",
            "license": "24870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MS

Sources for this page

Verify at the official NPI Registry.