Active NPI
Forrest General Hospital
- Clinical Medical Laboratory
- Hattiesburg, MS
National Provider Identifier
1417545922
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- Legal business name
- FORREST GENERAL HOSPITAL
- Practice address
- 415 S 28TH Ave
Hattiesburg, MS 39401-7283 - Phone
- (601) 264-6000
- NPI assigned
- Jan 10, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Prof. Jacob Cornelius Parker, DO MD PHD
- Title
- Specialist Technologist
- Phone
- (601) 264-6000
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Physician Chiropractor | 111NS0005X | |||
| Clinical Medical Laboratory | 291U00000X | Primary |
Addresses
Primary practice location
415 S 28TH Ave
Hattiesburg, MS 39401-7283
Mailing address
6051 U S Highway 49
Hattiesburg, MS 39401-7200
Phone (601) 288-7000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 84-2004221-3 | Other | VA | ZOHO HEALTHCARE PROVIDER |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | HTTPS://1UP.HEALTH | Direct |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1610236800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1610496000000",
"number": "1417545922",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6051 U S HIGHWAY 49",
"city": "HATTIESBURG",
"state": "MS",
"postal_code": "394017200",
"telephone_number": "601-288-7000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "415 S 28TH AVE",
"city": "HATTIESBURG",
"state": "MS",
"postal_code": "394017283",
"telephone_number": "601-264-6000"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FORREST GENERAL HOSPITAL",
"organizational_subpart": "NO",
"enumeration_date": "2021-01-10",
"last_updated": "2021-01-13",
"certification_date": "2021-01-13",
"status": "A",
"authorized_official_last_name": "PARKER",
"authorized_official_first_name": "JACOB",
"authorized_official_middle_name": "CORNELIUS",
"authorized_official_title_or_position": "SPECIALIST TECHNOLOGIST",
"authorized_official_telephone_number": "601-264-6000",
"authorized_official_name_prefix": "Prof.",
"authorized_official_credential": "DO MD PHD"
},
"taxonomies": [
{
"code": "111NS0005X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Chiropractor, Sports Physician",
"state": null,
"license": null,
"primary": false
},
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ZOHO HEALTHCARE PROVIDER",
"identifier": "84-2004221-3",
"state": "VA"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "HTTPS://1UP.HEALTH",
"affiliation": "N",
"endpointDescription": "PRODUCTIONS APP",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "415 S 28th Ave",
"city": "Hattiesburg",
"state": "MS",
"country_code": "US",
"postal_code": "394017283",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Jan 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.