NPIMap

Individual provider Active NPI

James Wilfred Ervin Jr., M.D.

  • Family Medicine Physician
  • Crystal Springs, MS
National Provider Identifier
1619903580
Registry record updated Nov 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
11355 Issued in MS
Practice address
104 W Railroad Ave S
Crystal Springs, MS 39059-2111
Phone
(601) 892-3063
Fax
(601) 892-3570
NPI assigned
Jun 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 11355 MS Primary

Addresses

Primary practice location

104 W Railroad Ave S
Crystal Springs, MS 39059-2111

Mailing address

104 W Railroad Ave S
Crystal Springs, MS 39059-2111
Phone (601) 892-3063

Other identifiers 1

IdentifierTypeStateIssuer
06726832MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040712001528 MS Practitioner - Family Practice 9638157332 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Mississippi School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Medical Clinic of Crystal Springs PLLCGroup PAC ID 6002894706, 3 clinicians

Practice addresses (Care Compare)

104 W Railroad Ave S
Crystal Springs, MS 39059-2111
Phone (601) 892-3063

Hospital & facility affiliations

  • Sta Home Health Agency of Jackson, Inc. Dba Accentcare Home Health of Jackson Home health agency, Clinton, MS, CCN 257102
  • Mississippi Homecare of Jackson Home health agency, Jackson, MS, CCN 257082
  • Copiah County Medical Center Hospital, Hazlehurst, MS, CCN 251327
  • St Dominic-Jackson Memorial Hospital Hospital, Jackson, MS, CCN 250048
  • Mississippi Baptist Medical Center Hospital, Jackson, MS, CCN 250102
  • King'S Daughters Medical Center-Brookhaven Hospital, Brookhaven, MS, CCN 250057
  • Copiah Living Center Nursing home, Crystal Springs, MS, CCN 255291

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions21
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy28

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
11355MSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Medical Clinic of Crystal Springs PLLC Family Medicine CurrentSince Jan 1, 2004 Accepting new patients
River Oaks Management Company LLC Family Medicine Past Accepting new patients

Locations

104 W Railroad Ave S
Crystal Springs, MS 39059
Phone (601) 892-3063

Organizations & group practices 2

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763424000000",
    "number": "1619903580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 W RAILROAD AVE S",
            "city": "CRYSTAL SPRINGS",
            "state": "MS",
            "postal_code": "390592111",
            "telephone_number": "601-892-3063",
            "fax_number": "888-927-0375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 W RAILROAD AVE S",
            "city": "CRYSTAL SPRINGS",
            "state": "MS",
            "postal_code": "390592111",
            "telephone_number": "601-892-3063",
            "fax_number": "601-892-3570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERVIN",
        "first_name": "JAMES",
        "middle_name": "WILFRED",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2025-11-18",
        "certification_date": "2025-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "11355",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06726832",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Springs, MS

Sources for this page

Verify at the official NPI Registry.