Organization Active NPI

Ms Pain & Migraine

  • Pain Medicine Physician
  • Southaven, MS
National Provider Identifier
1346098035
Registry record updated May 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
Legal business name
MS PAIN & MIGRAINE
Practice address
3495 Cobblestone Blvd
Southaven, MS 38672
Phone
(601) 582-6069
NPI assigned
May 8, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2024

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

Authorized official

Name
Jory Scott
Title
Owner
Phone
(601) 270-4313

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208VP0000X Primary

Addresses

Primary practice location

3495 Cobblestone Blvd
Southaven, MS 38672

Mailing address

4 Willow PT Ste 1
Hattiesburg, MS 39402-1150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210329000361 MS Part B Supplier - Clinic/Group Practice 5496162026 Receives reassigned benefits from 7 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Southaven, MS; Hattiesburg, MS

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Ms Pain Migraine2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3495 Cobblestone Blvd N
Southaven, MS 38672
Phone (601) 582-6069

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1715126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715126400000",
    "number": "1346098035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 WILLOW PT STE 1",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3495 COBBLESTONE BLVD",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "38672",
            "telephone_number": "601-582-6069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MS PAIN & MIGRAINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-08",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-02",
        "status": "A",
        "authorized_official_last_name": "SCOTT",
        "authorized_official_first_name": "JORY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-270-4313"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southaven, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.