South Mississippi Emergency Physicians,PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

SOUTH MISSISSIPPI EMERGENCY PHYSICIANS,PA

Practice address

4891 Highway 589
Sumrall, MS 39482-4453

Phone

(601) 758-4606

Fax

(601) 758-4615

NPI assigned

Jul 25, 2007

Last updated

Jan 22, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

John Nelson, M.D.NPI 1366470056

Title

President

Phone

(601) 288-2010

Specialties & licenses 1

Addresses

Practitioners 5

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.

• John Clayton Nelson, MD

  • Family Medicine Physician
  • Petal, MS
  • NPI 1366470056
  NPD Authorized official
• William Walker, MD

  • Family Medicine Physician
  • Sumrall, MS
  • NPI 1184668246
  NPD
• Lyndell Sue Lee, FNP

  • Family Nurse Practitioner
  • Hattiesburg, MS
  • NPI 1013951854
  NPD (past)
• Robert C Owen, M.D.

  • Emergency Medicine Physician
  • Hattiesburg, MS
  • NPI 1073544615
  NPD (past)
• Trent Woods, MD

  • Emergency Medicine Physician
  • Hattiesburg, MS
  • NPI 1104852037
  NPD (past)

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

{
    "created_epoch": "1185321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611273600000",
    "number": "1356531594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 635614",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452630001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4891 HIGHWAY 589",
            "city": "SUMRALL",
            "state": "MS",
            "postal_code": "394824453",
            "telephone_number": "601-758-4606",
            "fax_number": "601-758-4615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH MISSISSIPPI EMERGENCY PHYSICIANS,PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-25",
        "last_updated": "2021-01-22",
        "certification_date": "2021-01-06",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "601-288-2010",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly R Schramm, PT
• Serene Adult Care
• Craig Simm
• Brandon Coby Smith, AANP, FNP-C, ENP-C
• Sarah Alyssa Smith, FNP-C
• Southeast Mississippi Rural Health Initiative, Inc. (Sumrall High School)
• Southern Saferide Transportation
• Austin Laroy Stringer, PT
• Sarah Stroud, MS, RD, LD
• Sumrall Drug Store LLC (Sumrall Drug Store)

• Family Medicine Physician in Sumrall, MS
• Providers in Sumrall, MS by specialty
• Family Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 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.