Clarence Michael Osborne, MD

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

12145 Issued in MS

Practice address

2550 Flowood Drive
Suite 303
Flowood, MS 39232

Phone

(601) 709-7700

Fax

(601) 709-7701

NPI assigned

Oct 5, 2006

Last updated

Feb 23, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cmosborne@mentsa.gwaydirect.com

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.

• Mississippi Ear, Nose and Throat Surgical Associates, PC

  • Specialist
  • Flowood, MS
  • NPI 1679905210
  Medicare reassignment NPD Authorized official
• Mississippi Ear, Nose and Throat Surgical Associates

  • Otolaryngology Physician
  • Jackson, MS
  • NPI 1679617773
  Authorized official Same address or phone
• Jackson Ear, Nose and Throat PA

  • Otolaryngology Physician
  • Jackson, MS
  • NPI 1770790214
  NPD (past)

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456185600000",
    "number": "1548356983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 FLOWOOD DRIVE",
            "address_2": "SUITE 303",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "39232",
            "telephone_number": "601-709-7700",
            "fax_number": "601-709-7701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 FLOWOOD DRIVE",
            "address_2": "SUITE 303",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "39232",
            "telephone_number": "601-709-7700",
            "fax_number": "601-709-7701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSBORNE",
        "first_name": "CLARENCE",
        "middle_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2016-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MS",
            "license": "12145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Open MRI of Jackson, LLC
• Oral and Facial Surgery of Mississippi
• Joseph Griffin Orr, CRNA
• Billy Clifton Osbon Jr., R.PH.
• Gregory Lee Osborn, RPH
• Dale Allan Ostrowski, PA-C
• Charles Andrew Ouzts, M.D.
• Anniston I Owen
• Britney Owens
• Thomas Edward Panico, M.D.

• Otolaryngology Physician in Flowood, MS
• Providers in Flowood, MS by specialty
• Otolaryngology Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.