NPIMap

Organization Active NPI

Relias Emergency Medicine Specialists of Hattiesburg LLC

  • Emergency Medicine Physician
  • Hattiesburg, MS
National Provider Identifier
1609409440
Registry record updated Oct 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
RELIAS EMERGENCY MEDICINE SPECIALISTS OF HATTIESBURG LLC
Practice address
6051 U S Highway 49
Hattiesburg, MS 39401-7200
Phone
(662) 432-4106
NPI assigned
Feb 20, 2020
Last updated
Oct 16, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2025

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

Authorized official

Name
Jennifer Kathryn Wakeford
Title
Enterprise Cfo
Phone
(205) 901-5103

Specialties & licenses 1

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

Addresses

Primary practice location

6051 U S Highway 49
Hattiesburg, MS 39401-7200

Mailing address

PO Box 30275
Charlotte, NC 28230-0275
Phone (662) 432-4106

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200413002970 MS Part B Supplier - Clinic/Group Practice 9032549142 Receives reassigned benefits from 111 practitioners
Practice locations: Hattiesburg, MS

National Provider Directory

National Provider Directory

Locations

6051 U S Highway 49
Hattiesburg, MS 39401
Phone (601) 288-2690

Practitioners & affiliated clinicians

Practitioners 111

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.

View all 111

NPI Registry JSON

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

{
    "created_epoch": "1582156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760572800000",
    "number": "1609409440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30275",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282300275",
            "telephone_number": "662-432-4106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6051 U S HIGHWAY 49",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017200",
            "telephone_number": "662-432-4106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RELIAS EMERGENCY MEDICINE SPECIALISTS OF HATTIESBURG LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-20",
        "last_updated": "2025-10-16",
        "certification_date": "2025-10-16",
        "status": "A",
        "authorized_official_last_name": "WAKEFORD",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "KATHRYN",
        "authorized_official_title_or_position": "ENTERPRISE CFO",
        "authorized_official_telephone_number": "205-901-5103"
    },
    "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 Hattiesburg, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.