NPIMap

Individual provider Active NPI

Cody Caston Choate, D.O.

  • Family Medicine Physician
  • Columbia, MS
National Provider Identifier
1487064697
Registry record updated Aug 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
24243 Issued in MS
Practice address
502 Broad St
Columbia, MS 39429-3037
Phone
(601) 736-8282
NPI assigned
Apr 28, 2014
Last updated
Aug 11, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 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 24243 MS Primary

Addresses

Primary practice location

502 Broad St
Columbia, MS 39429-3037

Mailing address

415 S 28TH Ave
Hattiesburg, MS 39401-7246
Phone (601) 736-8282

Other identifiers 1

IdentifierTypeStateIssuer
01926042MedicaidMS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cchoate62202@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
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170731000601 MS Practitioner - Family Practice 4688961428 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
William Carey University College of Osteopathic Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24243MSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Forrest County General Hospital CurrentSince Sep 1, 2018 Accepting new patients
Forrest General Hospital CurrentSince Sep 1, 2018 Accepting new patients
Forrest County General Hospital Current Accepting new patients
Hattiesburg Clinic PA CurrentSince Jul 1, 2017 Accepting new patients
Hattiesburg Clinic, PA CurrentSince Jul 1, 2017 Accepting new patients
State of Mississippi - University of Mississippi Medical Center Past Accepting new patients

Locations

502 Broad St
Columbia, MS 39429
Phone (601) 736-8282

2117 Broadway Dr
Hattiesburg, MS 39402
Phone (601) 288-8050

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

415 S 28th Ave
Fl 1
Hattiesburg, MS 39401
Phone (601) 288-5200

6051 U S Highway 49
Hattiesburg, MS 39401
Phone (601) 288-2690

Interoperability endpoints

  • Direct secure messaging: cchoate62202@directpatientrecord.com

Organizations & group practices 6

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 6

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": "1398643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597104000000",
    "number": "1487064697",
    "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": "601-736-8282",
            "fax_number": "601-579-5240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 BROAD ST",
            "city": "COLUMBIA",
            "state": "MS",
            "postal_code": "394293037",
            "telephone_number": "601-736-8282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOATE",
        "first_name": "CODY",
        "middle_name": "CASTON",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-28",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "24243",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01926042",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cchoate62202@directpatientrecord.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "502 Broad St",
            "city": "Columbia",
            "state": "MS",
            "country_code": "US",
            "postal_code": "394293037",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbia, MS

Sources for this page

Verify at the official NPI Registry.