Nathaniel Nowacki, M.D.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

26713 Issued in MS

Practice address

415 S 28TH Ave
Hattiesburg, MS 39401-7246

Phone

(601) 288-4329

Fax

(601) 288-3191

NPI assigned

May 1, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Neurology

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Forrest County General HospitalGroup PAC ID 1052397767, 107 clinicians

FGH Physician BillingGroup PAC ID 1850344946, 27 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Forrest General Hospital Hospital, Hattiesburg, MS, CCN 250078
• St Dominic-Jackson Memorial Hospital Hospital, Jackson, MS, CCN 250048
• University of Mississippi Med Center Hospital, Jackson, MS, CCN 250001

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• FGH Physician Billing

  • Cardiovascular Disease Physician
  • Hattiesburg, MS
  • NPI 1053469700

  Neurology

  Medicare reassignment Care Compare group NPD
• Forrest County General Hospital

  • Psychiatric Hospital Unit
  • Hattiesburg, MS
  • NPI 1295837631
  Medicare reassignment Care Compare group NPD
• Hattiesburg Clinic PA

  • Multi-Specialty Clinic/Center
  • Hattiesburg, MS
  • NPI 1740213446
  Medicare reassignment NPD
• Forrest County General Hospital

  • Rural Health Clinic/Center
  • Picayune, MS
  • NPI 1043820426
  NPD
• Forrest General Hospital

  • Internal Medicine Physician
  • Hattiesburg, MS
  • NPI 1053512087
  NPD
• Hattiesburg Clinic, PA

  • Primary Care Clinic/Center
  • Flowood, MS
  • NPI 1912600354
  NPD
• Forrest County General Hospital

  • General Acute Care Hospital
  • Hattiesburg, MS
  • NPI 1225041809
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Forrest County General Hospital

  • General Acute Care Hospital
  • Hattiesburg, MS
  • NPI 1225041809
  Care Compare affiliation
• St Dominic-Jackson Memorial Hospital

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1306876065
  Care Compare affiliation
• State of Mississippi - University of Mississippi Medical Center

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1154317527
  Care Compare affiliation

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

{
    "created_epoch": "1367366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567123200000",
    "number": "1508201872",
    "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": "601-288-4329",
            "fax_number": "601-288-3191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 S 28TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017246",
            "telephone_number": "601-288-4329",
            "fax_number": "601-288-3191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOWACKI",
        "first_name": "NATHANIEL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-01",
        "last_updated": "2019-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MS",
            "license": "26713",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05304297",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aretha M. Northington, PMHNP
• Timothy W Norton, MD
• Holly D Norwood, PHARMD
• Jana M. Norwood, LPC
• Heather Nosky, MS, ATC, LAT, CES
• Shambraell Ro'Sha Nunnery
• Nursetel
• Nursetel LLC
• Nurturing Hearts L.L.C.
• Dawn Marie O'Keefe, PT

• Neurology Physician in Hattiesburg, MS
• Providers in Hattiesburg, MS by specialty
• Neurology Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.