NPIMap

Organization Active NPI

Mississippi Urology Clinic, PLLC

  • Non-Pharmacy Dispensing Site
  • Flowood, MS
National Provider Identifier
1487432852
Registry record updated Sep 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
Legal business name
MISSISSIPPI UROLOGY CLINIC, PLLC
Doing business as
Mississippi Urology Clinic, PLLC
Practice address
1040 River Oaks Dr Ste 202
Flowood, MS 39232-9534
Phone
(601) 353-9900
Fax
(601) 414-5381
NPI assigned
Sep 18, 2023
Last updated
Sep 18, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2023

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

Authorized official

Name
Dr. Harold Jason Blalock, MDNPI 1730118696
Title
President
Phone
(601) 353-9900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X NU Primary

Addresses

Primary practice location

1040 River Oaks Dr Ste 202
Flowood, MS 39232-9534

Mailing address

501 Marshall St Ste 301
Jackson, MS 39202-1687
Phone (601) 353-9900

Other names 1

  • Mississippi Urology Clinic, PLLC Doing business as

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.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
25D2285495Mississippi Urology Clinic1040 River Oaks Dr Ste 202, Flowood, MS 39232ComplianceDec 27, 2027

National Provider Directory

National Provider Directory
Tax ID family
Mississippi Urology Clinic PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

1040 River Oaks Dr
Ste 202
Jackson, MS 39232

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/uc32520_mississippiurologyclinic

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1694995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694995200000",
    "number": "1487432852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 MARSHALL ST STE 301",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392021687",
            "telephone_number": "601-353-9900",
            "fax_number": "601-353-3654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 RIVER OAKS DR STE 202",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329534",
            "telephone_number": "601-353-9900",
            "fax_number": "601-414-5381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSISSIPPI UROLOGY CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-18",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A",
        "authorized_official_last_name": "BLALOCK",
        "authorized_official_first_name": "HAROLD",
        "authorized_official_middle_name": "JASON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "601-353-9900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mississippi Urology Clinic, PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Flowood, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.