Individual provider Active NPI

Pearl Gizelle Myers, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Hattiesburg, MS
National Provider Identifier
1386950384
Registry record updated Oct 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
21283 Issued in MS
Practice address
155 Cross Creek Pkwy
Apt 315
Hattiesburg, MS 39402-4434
Phone
(601) 520-4268
NPI assigned
Aug 27, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology Physician 207ZP0101X 296142-1 NY
Anatomic Pathology Physician 207ZP0101X 30590 SC
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 296142-1 NY
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 21283 MS Primary

Addresses

Primary practice location

155 Cross Creek Pkwy
Apt 315
Hattiesburg, MS 39402-4434

Mailing address

24 Mayer Dr
Middletown, NY 10940-3348
Phone (601) 520-4268

Other practice location 1

24 Mayer Dr
Middletown, NY 10940-3348
Phone (601) 520-4268

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
21283MSMDAnatomic Pathology & Clinical Pathology Physician
296142-1NYMDAnatomic Pathology & Clinical Pathology Physician
30590SCMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1282867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540080000000",
    "number": "1386950384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 MAYER DR",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109403348",
            "telephone_number": "601-520-4268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 CROSS CREEK PKWY",
            "address_2": "APT 315",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394024434",
            "telephone_number": "601-520-4268"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24 Mayer Dr",
            "address_purpose": "LOCATION",
            "city": "Middletown",
            "state": "NY",
            "postal_code": "109403348",
            "country_code": "US",
            "telephone_number": "601-520-4268",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MYERS",
        "first_name": "PEARL",
        "middle_name": "GIZELLE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-27",
        "last_updated": "2018-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "NY",
            "license": "296142-1",
            "primary": false
        },
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "SC",
            "license": "30590",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NY",
            "license": "296142-1",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MS",
            "license": "21283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2018; 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.