NPIMap

Organization Active NPI

Chickasawhay Emergency Physicians LLC

  • Emergency Medicine Physician
  • Quitman, MS
National Provider Identifier
1508048489
Registry record updated Aug 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
CHICKASAWHAY EMERGENCY PHYSICIANS LLC
Practice address
605 S Archusa Ave
Quitman, MS 39355-2331
Phone
(601) 776-6925
Fax
(601) 776-7141
NPI assigned
Dec 3, 2007
Last updated
Aug 19, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2019

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

Authorized official

Name
Kathleen Kondas
Title
Officer
Phone
(954) 838-2371

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X Primary

Addresses

Primary practice location

605 S Archusa Ave
Quitman, MS 39355-2331

Mailing address

13737 Noel Rd
Ste 1600
Dallas, TX 75240-1331
Phone (954) 838-2371

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

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": "1196640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566172800000",
    "number": "1508048489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13737 NOEL RD",
            "address_2": "STE 1600",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752401331",
            "telephone_number": "954-838-2371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 S ARCHUSA AVE",
            "city": "QUITMAN",
            "state": "MS",
            "postal_code": "393552331",
            "telephone_number": "601-776-6925",
            "fax_number": "601-776-7141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHICKASAWHAY EMERGENCY PHYSICIANS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-03",
        "last_updated": "2019-08-19",
        "status": "A",
        "authorized_official_last_name": "KONDAS",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "954-838-2371"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quitman, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.