NPIMap

Organization Active NPI

Jones County Medical Supplies, Inc

Doing business as Hattiesburg Medical Supply

  • Durable Medical Equipment & Medical Supplies
  • Hattiesburg, MS
National Provider Identifier
1467415414
Registry record updated May 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
04318/11.1 Issued in MS
Legal business name
JONES COUNTY MEDICAL SUPPLIES, INC
Doing business as
Hattiesburg Medical Supply
Practice address
1301 S 28TH Ave
Hattiesburg, MS 39402-3106
Phone
(601) 296-6000
Fax
(601) 296-2020
NPI assigned
Apr 10, 2006
Organization subpart
Yes
Parent organization
JONES COUNTY MEDICAL SUPPLIES, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 8, 2026

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

Authorized official

Name
Mr. Clayton E Johnson
Title
Ceo
Phone
(601) 296-6000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 04318/11.1 MS Primary

Addresses

Primary practice location

1301 S 28TH Ave
Hattiesburg, MS 39402-3106

Mailing address

PO Box 23
Laurel, MS 39441-0023
Phone (601) 296-6000

Other identifiers 1

IdentifierTypeStateIssuer
00440537MedicaidMS

Other names 1

  • HATTIESBURG MEDICAL SUPPLY Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930075945 MS DME Supplier - Medical Supply CompanyDME Supplier - Pedorthic PersonnelDME Supplier - Oxygen & EquipmentDME Supplier - Medical Supply Company With Respiratory TherapistDME Supplier - Medical Supply Company With Orthotic PersonnelDME Supplier - Orthotic Personnel 7911955927 Practice locations: Hattiesburg, MS

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Jones County Medical Supplies, Inc1301 S 28TH Ave, Hattiesburg, MS 39402-3106(601) 296-6000 Commodes, Urinals, Bedpans|Continuous Passive Motion (CPM) Devices|Contracture Treatment Devices: Dynamic Splint|Blood Glucose Monitors/Supplies (Non-Mail Order)|Blood Glucose Monitors/Supplies (Mail Order)|Gastric Suction Pumps|Heat & Cold Applications|Hospital Beds (Electric)|Hospital Beds (Manua… Does not accept assignmentParticipating since Oct 1, 1979

National Provider Directory

National Provider Directory
Tax ID family
Jones County Med Suppli8 organizations share this tax ID, including this one
Part of
Jones County Med Suppli

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

205 Main St
Collins, MS 39428
Phone (601) 765-3277

9095 Highway 49
Gulfport, MS 39503
Phone (228) 241-2100

6424 U S Highway 98
Ste 20
Hattiesburg, MS 39402

865 E Broad St
Ste A
Monticello, MS 39654

709 Azalea Dr
Waynesboro, MS 39367
Phone (601) 735-3144

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778198400000",
    "number": "1467415414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394410023",
            "telephone_number": "601-296-6000",
            "fax_number": "601-296-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 S 28TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394023106",
            "telephone_number": "601-296-6000",
            "fax_number": "601-296-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JONES COUNTY MEDICAL SUPPLIES, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JONES COUNTY MEDICAL SUPPLIES, INC",
        "enumeration_date": "2006-04-10",
        "last_updated": "2026-05-08",
        "certification_date": "2026-05-08",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "CLAYTON",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "601-296-6000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MS",
            "license": "04318/11.1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00440537",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HATTIESBURG MEDICAL SUPPLY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "HATTIESBURG MEDICAL SUPPLY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 May 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.