NPIMap

Organization Active NPI

Hattiesburg Clinic, PA

  • Family Medicine Physician
  • Lumberton, MS
National Provider Identifier
1346780681
Registry record updated Feb 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
HATTIESBURG CLINIC, PA
Practice address
202 E Main Ave
Lumberton, MS 39455-2608
Phone
(601) 796-7030
Fax
(601) 796-7956
NPI assigned
Mar 6, 2017
Last updated
Feb 18, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2021

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

Authorized official

Name
Bryan N Batson, MD
Title
Executive Director
Phone
(601) 264-6000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

202 E Main Ave
Lumberton, MS 39455-2608

Mailing address

415 S 28TH Ave
Hattiesburg, MS 39401-7246
Phone (601) 796-7030

Other names 1

  • Lumberton Family Medicine Other name

National Provider Directory

National Provider Directory
Tax ID family
Hattiesburg Clinic PA136 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

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": "1488758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613606400000",
    "number": "1346780681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 S 28TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017246",
            "telephone_number": "601-796-7030",
            "fax_number": "601-579-5240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 E MAIN AVE",
            "city": "LUMBERTON",
            "state": "MS",
            "postal_code": "394552608",
            "telephone_number": "601-796-7030",
            "fax_number": "601-796-7956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HATTIESBURG CLINIC, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-06",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-18",
        "status": "A",
        "authorized_official_last_name": "BATSON",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "601-264-6000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lumberton Family Medicine",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Lumberton Family Medicine",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lumberton, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2021; 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.