Organization Active NPI

Highway 15 Medical Clinic PA

  • Rural Health Clinic/Center
  • New Albany, MS
National Provider Identifier
1417949058
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
HIGHWAY 15 MEDICAL CLINIC PA
Practice address
124 Highway 15 S
New Albany, MS 38652-5225
Phone
(662) 534-4706
Fax
(662) 534-8065
NPI assigned
Aug 19, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. James Lee Thornton III, M.D.
Title
President
Phone
(662) 534-4706

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

124 Highway 15 S
New Albany, MS 38652-5225

Mailing address

124 Highway 15 S
New Albany, MS 38652-5225
Phone (662) 534-4706

Other identifiers 1

IdentifierTypeStateIssuer
09016044MedicaidMS

National Provider Directory

National Provider Directory

Locations

124 State Highway 15 S
New Albany, MS 38652
Phone (601) 534-4706

NPI Registry JSON

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

{
    "created_epoch": "1124409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1417949058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 HIGHWAY 15 S",
            "city": "NEW ALBANY",
            "state": "MS",
            "postal_code": "386525225",
            "telephone_number": "662-534-4706",
            "fax_number": "662-534-8065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 HIGHWAY 15 S",
            "city": "NEW ALBANY",
            "state": "MS",
            "postal_code": "386525225",
            "telephone_number": "662-534-4706",
            "fax_number": "662-534-8065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGHWAY 15 MEDICAL CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "THORNTON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "662-534-4706",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09016044",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Albany, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.