NPIMap

Organization Active NPI

Acs Emergency Services of Mississippi Professional Association

  • Emergency Medicine Physician
  • Cleveland, MS
National Provider Identifier
1396996997
Registry record updated Sep 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
ACS EMERGENCY SERVICES OF MISSISSIPPI PROFESSIONAL ASSOCIATION
Practice address
901 E Sunflower Rd
Cleveland, MS 38732-2833
Phone
(662) 846-0061
NPI assigned
Oct 2, 2008
Last updated
Sep 14, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2020

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

Authorized official

Name
Dr. Randal L Dabbs, MD
Title
President
Phone
(865) 293-5210

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Nurse Practitioner 363L00000X NU
Emergency Medicine Physician 207P00000X NU Primary

Addresses

Primary practice location

901 E Sunflower Rd
Cleveland, MS 38732-2833

Mailing address

PO Box 636232
Cincinnati, OH 45263-6232
Phone (800) 424-3672

Other identifiers 1

IdentifierTypeStateIssuer
05726769MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081222000668 MS Part B Supplier - Clinic/Group Practice 7719049998 Receives reassigned benefits from 32 practitioners
Practice locations: Cleveland, MS

National Provider Directory

National Provider Directory

Locations

901 E Sunflower Rd
Cleveland, MS 38732
Phone (662) 846-0061

Practitioners & affiliated clinicians

Practitioners 53

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.

View all 53

NPI Registry JSON

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

{
    "created_epoch": "1222905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600041600000",
    "number": "1396996997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 636232",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452636232",
            "telephone_number": "800-424-3672",
            "fax_number": "954-377-3042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 E SUNFLOWER RD",
            "city": "CLEVELAND",
            "state": "MS",
            "postal_code": "387322833",
            "telephone_number": "662-846-0061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACS EMERGENCY SERVICES OF MISSISSIPPI PROFESSIONAL ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-02",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-14",
        "status": "A",
        "authorized_official_last_name": "DABBS",
        "authorized_official_first_name": "RANDAL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "865-293-5210",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05726769",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.