Individual provider Active NPI

Cathy McGruder

  • Early Intervention Provider Agency
  • Canton, MS
National Provider Identifier
1346919263
Registry record updated Sep 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
Practice address
129 Willie Burrell Dr
Canton, MS 39046-9550
Phone
(601) 540-4781
NPI assigned
Sep 13, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X Primary

Addresses

Primary practice location

129 Willie Burrell Dr
Canton, MS 39046-9550

Mailing address

129 Willie Burrell Dr
Canton, MS 39046-9550
Phone (601) 540-4781

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL Laptop
CONNECT URL LAPTOP

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1631491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631491200000",
    "number": "1346919263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 WILLIE BURRELL DR",
            "city": "CANTON",
            "state": "MS",
            "postal_code": "390469550",
            "telephone_number": "601-540-4781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 WILLIE BURRELL DR",
            "city": "CANTON",
            "state": "MS",
            "postal_code": "390469550",
            "telephone_number": "601-540-4781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGRUDER",
        "first_name": "CATHY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-13",
        "last_updated": "2021-09-13",
        "certification_date": "2021-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Laptop",
            "affiliation": "N",
            "address_1": "129 Willie Burrell Dr",
            "city": "Canton",
            "state": "MS",
            "country_code": "US",
            "postal_code": "390469550",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "LAPTOP",
            "affiliation": "N",
            "address_1": "129 Willie Burrell Dr",
            "city": "Canton",
            "state": "MS",
            "country_code": "US",
            "postal_code": "390469550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Canton, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 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.