Active NPI
Jan T McClanahan, MD
- Surgery Physician
- Columbus, MS
National Provider Identifier
1609873488
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 19458
- Practice address
- 255 Baptist Blvd.
Suite 407
Columbus, MS 39705-2004 - Phone
- (662) 241-4223
- Fax
- (662) 241-4460
- NPI assigned
- Jul 7, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 19458 | MS | Primary |
Addresses
Primary practice location
255 Baptist Blvd.
Suite 407
Columbus, MS 39705-2004
Mailing address
PO Box 405827
Atlanta, GA 30384-5800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03730025 | Medicaid | MS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11194 | LA | MD | Clinical Social Worker |
| 19458 | MS | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1477008000000",
"number": "1609873488",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 405827",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303845800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "255 BAPTIST BLVD.",
"address_2": "SUITE 407",
"city": "COLUMBUS",
"state": "MS",
"postal_code": "397052004",
"telephone_number": "662-241-4223",
"fax_number": "662-241-4460"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCLANAHAN",
"first_name": "JAN",
"middle_name": "T",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-07",
"last_updated": "2016-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MS",
"license": "19458",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "03730025",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Columbus, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.