Organization Active NPI

Yoshinobu Namihira MD PA

  • Medical Specialty Clinic/Center
  • Vicksburg, MS
National Provider Identifier
1639268501
Registry record updated Apr 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
Legal business name
YOSHINOBU NAMIHIRA MD PA
Practice address
3000 Halls Ferry Rd
Vicksburg, MS 39180-4802
Phone
(601) 638-9800
Fax
(601) 638-9808
NPI assigned
Oct 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2008

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

Authorized official

Name
Yoshinobu Namihira, M.D.NPI 1871773671
Title
President
Phone
(601) 638-9800

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X Primary

Addresses

Primary practice location

3000 Halls Ferry Rd
Vicksburg, MS 39180-4802

Mailing address

3000 Halls Ferry Rd
Vicksburg, MS 39180-4802
Phone (601) 638-9800

Other identifiers 3

IdentifierTypeStateIssuer
00017743MedicaidMS
1366501MedicaidLA
110030246OtherMSRAIL ROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071220000175 MS Part B Supplier - Clinic/Group Practice 6709976244 Receives reassigned benefits from 1 practitioner
Practice locations: Vicksburg, MS

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
25D1012796Yoshinobu Namihira MD3000 Halls Ferry Road, Vicksburg, MS 39180Certificate of waiverMay 20, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208822400000",
    "number": "1639268501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 HALLS FERRY RD",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391804802",
            "telephone_number": "601-638-9800",
            "fax_number": "601-638-9808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 HALLS FERRY RD",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391804802",
            "telephone_number": "601-638-9800",
            "fax_number": "601-638-9808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOSHINOBU NAMIHIRA MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2008-04-22",
        "status": "A",
        "authorized_official_last_name": "NAMIHIRA",
        "authorized_official_first_name": "YOSHINOBU",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "601-638-9800",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00017743",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1366501",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "110030246",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vicksburg, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.