Domenic P Esposito, M.D.

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

16712 Issued in MS

Practice address

2500 N State St
N703 Neurosurgery Department
Jackson, MS 39216-4500

Phone

(601) 984-5706

Fax

(601) 984-6491

NPI assigned

May 30, 2006

Last updated

Nov 14, 2008By 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

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226620800000",
    "number": "1578510962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "address_2": "N703 NEUROSURGERY DEPARTMENT",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-5706",
            "fax_number": "601-984-6491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "address_2": "N703 NEUROSURGERY DEPARTMENT",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-5706",
            "fax_number": "601-984-6491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESPOSITO",
        "first_name": "DOMENIC",
        "middle_name": "P",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-30",
        "last_updated": "2008-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "MS",
            "license": "16712",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00122202",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR PTAN",
            "identifier": "140006643",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "2007 MCR",
            "identifier": "140000133",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Selcuk Erturk, MD
• Amaya Ervin, ST
• Malaysha Ervin
• Sarah Kelly Erwin, RDN, LD
• William Jeremy Erwin, M.D.
• Zerelda Esquer Garrigos, M.D.
• Angela Marie Essary, MS, LPC
• Cody Estep, MD
• Timothy Duncan Estes, M.D.
• Chris Phillip Ethridge, MD

• Neurological Surgery Physician in Jackson, MS
• Providers in Jackson, MS by specialty
• Neurological Surgery Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2008; 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.