Individual provider Active NPI

Keith Warren Simpson, DMD

  • Dentist
  • Yazoo City, MS
National Provider Identifier
1386614246
Registry record updated Sep 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
3209-01 Issued in MS
Practice address
2225 Haley Barbour Pkwy
Yazoo City, MS 39194-4796
Phone
(662) 751-4800
NPI assigned
Jan 24, 2006
Last updated
Sep 18, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 3209-01 MS Primary

Addresses

Primary practice location

2225 Haley Barbour Pkwy
Yazoo City, MS 39194-4796

Mailing address

2225 Haley Barbour Pkwy
PO Box 5666
Yazoo City, MS 39194-4796
Phone (662) 751-4800

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

State licenses

LicenseStateTypeSpecialty
3209-01MSMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Yazoo Federal Correctional Center Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379462400000",
    "number": "1386614246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2225 HALEY BARBOUR PKWY",
            "address_2": "PO BOX 5666",
            "city": "YAZOO CITY",
            "state": "MS",
            "postal_code": "391944796",
            "telephone_number": "662-751-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2225 HALEY BARBOUR PKWY",
            "city": "YAZOO CITY",
            "state": "MS",
            "postal_code": "391944796",
            "telephone_number": "662-751-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMPSON",
        "first_name": "KEITH",
        "middle_name": "WARREN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-24",
        "last_updated": "2013-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MS",
            "license": "3209-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yazoo City, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2013; 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.