Miss Reproductive Medicine PLLC

Primary specialty

Reproductive Endocrinology PhysicianTaxonomy code 207VE0102X

License

12123 Issued in MS

Legal business name

MISS REPRODUCTIVE MEDICINE PLLC

Practice address

1040 River Oaks Dr
Jackson, MS 39232-9530

Phone

(601) 936-3650

Fax

(866) 491-0274

NPI assigned

Aug 5, 2010

Last updated

Aug 5, 2010By 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

Dr. Randall S Hines, MDNPI 1306877634

Title

Owner

Phone

(601) 936-3650

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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.

• Randall Stuart Hines, M.D.

  • Reproductive Endocrinology Physician
  • Flowood, MS
  • NPI 1306877634
  NPD (past) Authorized official
• Marty B. Gebhart, CFNP

  • Family Nurse Practitioner
  • Jackson, MS
  • NPI 1568594208
  NPD (past)

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

{
    "created_epoch": "1280966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280966400000",
    "number": "1396059093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 RIVER OAKS DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392329530",
            "telephone_number": "601-936-3650",
            "fax_number": "866-491-0274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 RIVER OAKS DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392329530",
            "telephone_number": "601-936-3650",
            "fax_number": "866-491-0274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISS REPRODUCTIVE MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-05",
        "last_updated": "2010-08-05",
        "status": "A",
        "authorized_official_last_name": "HINES",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-936-3650",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207VE0102X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "MS",
            "license": "12123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Reproductive Endocrinology Physician in Jackson, MS
• Providers in Jackson, MS by specialty
• Reproductive Endocrinology Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2010; 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.