NPIMap

Organization Active NPI

Dr. Ronnie Harrison P.a.

  • General Practice Dentistry
  • Lucedale, MS
National Provider Identifier
1558418897
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2485 Issued in MS
Legal business name
DR. RONNIE HARRISON P.A.
Practice address
13 Plaza Drive
Lucedale, MS 39452
Phone
(601) 947-9530
Fax
(601) 947-9595
NPI assigned
Jan 5, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Ronald Ray Harrison, DMDNPI 1255420337
Title
Dentist
Phone
(601) 947-9530

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2485 MS Primary

Addresses

Primary practice location

13 Plaza Drive
Lucedale, MS 39452

Mailing address

PO Box 798
Lucedale, MS 39452-0798
Phone (601) 947-9530

Other identifiers 2

IdentifierTypeStateIssuer
00660149MedicaidMS
05237756MedicaidMS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1167955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1558418897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 798",
            "city": "LUCEDALE",
            "state": "MS",
            "postal_code": "394520798",
            "telephone_number": "601-947-9530",
            "fax_number": "601-947-9595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 PLAZA DRIVE",
            "city": "LUCEDALE",
            "state": "MS",
            "postal_code": "39452",
            "telephone_number": "601-947-9530",
            "fax_number": "601-947-9595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. RONNIE HARRISON P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HARRISON",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "RAY",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "601-947-9530",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": "2485",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00660149",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05237756",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lucedale, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.