NPIMap

Organization Active NPI

McComb Anesthesia Associates, LLP

  • Anesthesiology Physician
  • McComb, MS
National Provider Identifier
1619916533
Registry record updated Feb 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
MCCOMB ANESTHESIA ASSOCIATES, LLP
Practice address
215 Marion Ave
McComb, MS 39648-2705
Phone
(601) 936-0682
NPI assigned
Jun 6, 2006
Last updated
Feb 17, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2010

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

Authorized official

Name
Ashraf E. Riad, M.D.NPI 1013024322
Title
Partner
Phone
(601) 936-0682

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X NU
Anesthesiology Physician 207L00000X NU Primary

Addresses

Primary practice location

215 Marion Ave
McComb, MS 39648-2705

Mailing address

PO Box 4507
Jackson, MS 39296-4507
Phone (601) 936-0682

Other identifiers 2

IdentifierTypeStateIssuer
CN3408OtherRAILROAD MEDICARE
09014655MedicaidMS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040427000438 MS Part B Supplier - Clinic/Group Practice 6204823891 Receives reassigned benefits from 25 practitioners
Practice locations: McComb, MS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 25

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 25

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266364800000",
    "number": "1619916533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4507",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392964507",
            "telephone_number": "601-936-0682",
            "fax_number": "601-936-0686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 MARION AVE",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396482705",
            "telephone_number": "601-936-0682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCCOMB ANESTHESIA ASSOCIATES, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-06",
        "last_updated": "2010-02-17",
        "status": "A",
        "authorized_official_last_name": "RIAD",
        "authorized_official_first_name": "ASHRAF",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "601-936-0682",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CN3408",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09014655",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McComb, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2010; 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.