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Individual provider Active NPI

Lawrence L Line Jr., M.D.,

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Hattiesburg, MS
National Provider Identifier
1427087592
Registry record updated Dec 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
12369 Issued in MS
Practice address
3688 Veterans Memorial Dr
Suite 200
Hattiesburg, MS 39401-8246
Phone
(601) 554-7400
Fax
(601) 554-7488
NPI assigned
Jul 1, 2006
Last updated
Dec 23, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 12369 MS Primary

Addresses

Primary practice location

3688 Veterans Memorial Dr
Suite 200
Hattiesburg, MS 39401-8246

Mailing address

3688 Veterans Memorial Dr
Suite 200
Hattiesburg, MS 39401-8246
Phone (601) 554-7400

Other identifiers 1

IdentifierTypeStateIssuer
0114800MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100715000092 MS Practitioner - Orthopedic Surgery 4284789504 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Mississippi School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3688 Veterans Memorial Dr
Suite 200
Hattiesburg, MS 39401-8246
Phone (601) 554-7400

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
40.41 of 100Reported as individual
Quality
19.47
Promoting interoperability
49
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Knee replacement1-10
Lower limb (leg) arthroscopy (minimally invasive joint repair)21
Upper limb (arm) arthroscopy (minimally invasive joint repair)58

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
12369MSMDSports Medicine (Orthopaedic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Bone & Joint Specialists, PA Sports Medicine CurrentSince Mar 30, 1995 Accepting new patients
Southern Bone & Joint Specialists Sports Medicine CurrentSince Mar 30, 1995 Accepting new patients

Locations

1215 Highway 98 Byp
Columbia, MS 39429
Phone (601) 268-5070

3688 Veterans Memorial Dr
Ste 200
Hattiesburg, MS 39401
Phone (601) 554-7451

128 Highland Pkwy
Ste 100
Picayune, MS 39466

Interoperability endpoints

  • Direct secure messaging: lawrence.line.p1@direct.southernboneandjoint.nextgenshare.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261526400000",
    "number": "1427087592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3688 VETERANS MEMORIAL DR",
            "address_2": "SUITE 200",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394018246",
            "telephone_number": "601-554-7400",
            "fax_number": "601-554-7488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3688 VETERANS MEMORIAL DR",
            "address_2": "SUITE 200",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394018246",
            "telephone_number": "601-554-7400",
            "fax_number": "601-554-7488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINE",
        "first_name": "LAWRENCE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.,",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-01",
        "last_updated": "2009-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "MS",
            "license": "12369",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0114800",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

Verify at the official NPI Registry.