NPIMap

Organization Active NPI

Acs Emergency Physicians PA

  • Emergency Medicine Physician
  • Picayune, MS
National Provider Identifier
1649384512
Registry record updated Oct 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
ACS EMERGENCY PHYSICIANS PA
Practice address
801 Goodyear Blvd
Picayune, MS 39466-3221
Phone
(601) 798-4711
NPI assigned
Aug 18, 2006
Last updated
Oct 24, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2007

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

Authorized official

Name
Jackie Lane
Title
Cfo
Phone
(954) 475-1300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X Primary

Addresses

Primary practice location

801 Goodyear Blvd
Picayune, MS 39466-3221

Mailing address

1900 N Winston Rd
Suite 300
Knoxville, TN 37919-3606
Phone (954) 475-1300

Other identifiers 1

IdentifierTypeStateIssuer
7573234MedicaidMS

National Provider Directory

National Provider Directory

Locations

Dept 960295
Oklahoma City, OK 73196

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193184000000",
    "number": "1649384512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 N WINSTON RD",
            "address_2": "SUITE 300",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379193606",
            "telephone_number": "954-475-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 GOODYEAR BLVD",
            "city": "PICAYUNE",
            "state": "MS",
            "postal_code": "394663221",
            "telephone_number": "601-798-4711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACS EMERGENCY PHYSICIANS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-18",
        "last_updated": "2007-10-24",
        "status": "A",
        "authorized_official_last_name": "LANE",
        "authorized_official_first_name": "JACKIE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "954-475-1300"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7573234",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Picayune, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.