Individual provider Active NPI

Joseph R Danford, MD

  • Family Medicine Physician
  • Ellisville, MS
National Provider Identifier
1477561728
Registry record updated Jul 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
16860 Issued in MS
Practice address
822 Main St
Ellisville, MS 39437-2425
Phone
(601) 477-2014
Fax
(601) 477-9942
NPI assigned
Aug 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 16860 MS Primary

Addresses

Primary practice location

822 Main St
Ellisville, MS 39437-2425

Mailing address

415 S 28TH Ave
Hattiesburg, MS 39401-7246
Phone (601) 477-2014

Other identifiers 3

IdentifierTypeStateIssuer
1559334OtherMSAMERICAN ADMIN GROUP
00122374MedicaidMS
1682322MedicaidLA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ddanford2487@directpatientrecord.com Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080202000011 MS Practitioner - Family Practice 7810079555 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Louisiana State University School of Medicine in New Orleans, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hattiesburg Clinic PAGroup PAC ID 5193706794, 525 clinicians

Practice addresses (Care Compare)

415 S 28TH Ave
Hattiesburg, MS 39401-7246
Phone (601) 264-6000

Hospital & facility affiliations

  • Forrest General Home Care Home health agency, Hattiesburg, MS, CCN 257127
  • Enhabit Home Health & Hospice Home health agency, Hattiesburg, MS, CCN 257091
  • South Central Reg Med Ctr Hospital, Laurel, MS, CCN 250058
  • Forrest General Hospital Hospital, Hattiesburg, MS, CCN 250078

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hattiesburg Clinic PA CurrentSince Oct 25, 2007 Accepting new patients
Hattiesburg Clinic, PA CurrentSince Oct 25, 2007 Accepting new patients
Hattiesburg Clinic, PA Past Accepting new patients

Locations

822 Main St
Ellisville, MS 39437
Phone (601) 477-2014

415 S 28th Ave
Hattiesburg, MS 39401
Phone (601) 261-3606

Organizations & group practices 3

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

Hospital & facility affiliations 4

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": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594684800000",
    "number": "1477561728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 S 28TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017246",
            "telephone_number": "601-477-2014",
            "fax_number": "601-579-5240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "822 MAIN ST",
            "city": "ELLISVILLE",
            "state": "MS",
            "postal_code": "394372425",
            "telephone_number": "601-477-2014",
            "fax_number": "601-477-9942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANFORD",
        "first_name": "JOSEPH",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2020-07-14",
        "certification_date": "2020-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "16860",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN ADMIN GROUP",
            "identifier": "1559334",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00122374",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1682322",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ddanford2487@directpatientrecord.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "822 Main St",
            "city": "Ellisville",
            "state": "MS",
            "country_code": "US",
            "postal_code": "394372425",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ellisville, MS

Sources for this page

Verify at the official NPI Registry.