Active NPI
Ray E. Myatt, M.D.
- Obstetrics & Gynecology Physician
- Meridian, MS
National Provider Identifier
1326020173
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 08779
- Practice address
- 1800 12TH St
Meridian, MS 39301-4158 - Phone
- (601) 703-9222
- Fax
- (601) 703-6770
- NPI assigned
- Nov 17, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 08779 | MS | Primary |
Addresses
Primary practice location
1800 12TH St
Meridian, MS 39301-4158
Mailing address
PO Box 5183
Meridian, MS 39302-5183
Phone (601) 703-4282
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00115842 | Medicaid | MS | |
| 730-13118 | Other | BLUE CROSS OF AL | |
| 009940625 | Medicaid | AL | |
| P00113825 | Other | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 08779 | MS | MD | Obstetrics & Gynecology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132185600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1383782400000",
"number": "1326020173",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5183",
"city": "MERIDIAN",
"state": "MS",
"postal_code": "393025183",
"telephone_number": "601-703-4282",
"fax_number": "601-703-4597"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1800 12TH ST",
"city": "MERIDIAN",
"state": "MS",
"postal_code": "393014158",
"telephone_number": "601-703-9222",
"fax_number": "601-703-6770"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MYATT",
"first_name": "RAY",
"middle_name": "E.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-17",
"last_updated": "2013-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "MS",
"license": "08779",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00115842",
"state": "MS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS OF AL",
"identifier": "730-13118",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "009940625",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00113825",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Meridian, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 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.