Larry W Sivils, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

11084 Issued in MS

Practice address

935 Highway 51
Madison, MS 39110-8407

Phone

(601) 856-5986

Fax

(601) 853-2321

NPI assigned

Aug 5, 2006

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 1

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

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• First Intermed Corporation

  • Family Medicine Physician
  • Brandon, MS
  • NPI 1932133931
  NPD (past)
• Genesis PT and Rehab Services

  • Physical Therapy Clinic/Center
  • Ridgeland, MS
  • NPI 1184768376
  NPD (past)

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609885284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "935 HIGHWAY 51",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391108407",
            "telephone_number": "601-856-5986",
            "fax_number": "601-853-2321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "935 HIGHWAY 51",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391108407",
            "telephone_number": "601-856-5986",
            "fax_number": "601-853-2321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIVILS",
        "first_name": "LARRY",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "11084",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0114414",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Signature Smiles PLLC
• Russell E. Simkins, PHARMD
• Anne Marie Simmons, PHARMD
• John Christopher Simmons, CRNA
• Jessica C Sinclair, FNP-C
• Tyler Slay, LPC
• Sleepworks, Inc.
• Smartsmile Orthodontics, PLLC
• Amerial Smith
• Derrick Brice Smith, DPT

• Family Medicine Physician in Madison, MS
• Providers in Madison, MS by specialty
• Family Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.