North Mississippi Pulmonology Clinic Inc

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

07824 Issued in MS

Legal business name

NORTH MISSISSIPPI PULMONOLOGY CLINIC INC

Practice address

100 Hospital St
#300
Booneville, MS 38829-3354

Phone

(662) 728-2147

Fax

(662) 720-3050

NPI assigned

May 1, 2007

Organization subpart

No

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

Authorized official

Name

David G Chase, MD

Title

Owner

Phone

(662) 728-2147

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1376764167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL ST",
            "address_2": "#300",
            "city": "BOONEVILLE",
            "state": "MS",
            "postal_code": "388293354",
            "telephone_number": "662-728-2147",
            "fax_number": "662-720-3050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL ST",
            "address_2": "#300",
            "city": "BOONEVILLE",
            "state": "MS",
            "postal_code": "388293354",
            "telephone_number": "662-728-2147",
            "fax_number": "662-720-3050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH MISSISSIPPI PULMONOLOGY CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CHASE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "662-728-2147",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MS",
            "license": "07824",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09015803",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Booneville, MS
• Pulmonary Disease Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.