NPIMap

Organization Active NPI

Pacific Physician Services, LLC

  • General Practice Physician
  • Hattiesburg, MS
National Provider Identifier
1316968084
Registry record updated Jun 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
PACIFIC PHYSICIAN SERVICES, LLC
Practice address
200 Hospital Dr W
Hattiesburg, MS 39402-1346
Phone
(601) 296-3000
NPI assigned
Jul 21, 2006
Last updated
Jun 1, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2012

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

Authorized official

Name
Debbie Brewer
Title
Director
Phone
(877) 892-9813

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X NU Primary

Addresses

Primary practice location

200 Hospital Dr W
Hattiesburg, MS 39402-1346

Mailing address

PO Box 689022
Franklin, TN 37068-9022
Phone (615) 465-7000

Other identifiers 1

IdentifierTypeStateIssuer
00525592MedicaidMS

National Provider Directory

National Provider Directory

Locations

105 Asbury Cir
Hattiesburg, MS 39402
Phone (601) 268-5100

200 Hospital Dr W
Hattiesburg, MS 39402
Phone (601) 296-3000

425 E Central Ave
Petal, MS 39465
Phone (601) 584-4309

500 Portage Lakes Dr
Ste B
Coventry Township, OH 44319
Phone (330) 245-1608

8803 S 101st East Ave
Ste 145
Tulsa, OK 74133
Phone (918) 250-2033

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338508800000",
    "number": "1316968084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 689022",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370689022",
            "telephone_number": "615-465-7000",
            "fax_number": "615-465-3007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HOSPITAL DR W",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021346",
            "telephone_number": "601-296-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC PHYSICIAN SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-21",
        "last_updated": "2012-06-01",
        "status": "A",
        "authorized_official_last_name": "BREWER",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "877-892-9813"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00525592",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2012; 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.