Individual provider Active NPI

Daniel Boone, DO

  • Family Medicine Physician
  • McComb, MS
National Provider Identifier
1619926433
Registry record updated Feb 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
19021 Issued in MS
Practice address
1506 Aston Ave
McComb, MS 39648-2735
Phone
(601) 249-4415
Fax
(601) 249-4474
NPI assigned
May 9, 2006
Last updated
Feb 17, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2026

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 19021 MS Primary

Addresses

Primary practice location

1506 Aston Ave
McComb, MS 39648-2735

Mailing address

PO Box 490
McComb, MS 39649-0490
Phone (601) 250-4366

Other practice location 1

1167 E Broad St
Monticello, MS 39654-7682
Phone (601) 587-1433

Other practice location 2

200 Marion Ave
McComb, MS 39648-2706
Phone (601) 250-4381

Other identifiers 1

IdentifierTypeStateIssuer
02956343MedicaidMS

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20050822000934 MS Practitioner - Family Practice 9234160045 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Nova Southeastern College of Osteo Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwest Mississippi Regional Medical CenterGroup PAC ID 5193633907, shared by 11 NPIs, 82 clinicians

Practice addresses (Care Compare)

1167 E Broad St
Lawrence County Family Practice
Monticello, MS 39654-7682
Phone (601) 587-1433

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.09 of 100Reported as apm
Quality
73.43
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19021MSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Mississippi Regional Medical Center CurrentSince Aug 1, 2005 Accepting new patients
Southwest Mississippi Regional Medical Center CurrentSince Jul 1, 2021 Accepting new patients
Southwest Mississippi Regional Medical Center CurrentSince Aug 1, 2005 Accepting new patients
Southwest Mississippi Regional Medical Center Current Accepting new patients
Southwest Mississippi Regional Medical Center Past Accepting new patients

Locations

1506 Aston Ave
McComb, MS 39648
Phone (601) 249-4282

200 Marion Ave
McComb, MS 39648
Phone (601) 250-4381

215 Marion Ave
McComb, MS 39648
Phone (601) 249-1180

300 Rawls Dr
Ste 600
McComb, MS 39648
Phone (601) 249-4415

1167 E Broad St
Monticello, MS 39654
Phone (601) 587-1433

Interoperability endpoints

  • Direct secure messaging: dboone5074285@direct.casso.us.com

Organizations & group practices 5

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

Hospital & facility affiliations 2

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": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771286400000",
    "number": "1619926433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 490",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396490490",
            "telephone_number": "601-250-4366",
            "fax_number": "601-250-4367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1506 ASTON AVE",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396482735",
            "telephone_number": "601-249-4415",
            "fax_number": "601-249-4474"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1167 E Broad St",
            "address_purpose": "LOCATION",
            "city": "Monticello",
            "state": "MS",
            "postal_code": "396547682",
            "country_code": "US",
            "telephone_number": "601-587-1433",
            "fax_number": "601-587-1625",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 Marion Ave",
            "address_purpose": "LOCATION",
            "city": "McComb",
            "state": "MS",
            "postal_code": "396482706",
            "country_code": "US",
            "telephone_number": "601-250-4381",
            "fax_number": "601-250-4367",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOONE",
        "first_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-09",
        "last_updated": "2026-02-17",
        "certification_date": "2026-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "19021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02956343",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McComb, MS

Sources for this page

Verify at the official NPI Registry.