Active NPI
Yoshinobu Namihira MD PA
- Medical Specialty Clinic/Center
- Vicksburg, MS
National Provider Identifier
1639268501
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Specialty Clinic/Center
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Yoshinobu Namihira, M.D.
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00017743 | Medicaid | MS | |
| 1366501 | Medicaid | LA | |
| 110030246 | Other | MS | RAIL ROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MS
Enrollment records 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 25D1012796 | Yoshinobu Namihira MD | Certificate of waiver | May 20, 2027 |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Gastroenterology Physician
- Vicksburg, MS
- NPI 1871773671
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.