NPIMap

Individual provider Active NPI

James Allen Mestayer II, PHARMACIST

  • Pharmacist
  • Hattiesburg, MS
National Provider Identifier
1649690587
Registry record updated Apr 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
15787 Issued in LA
Practice address
5093 Hardy St
Hattiesburg, MS 39402
Phone
(601) 579-6698
NPI assigned
Apr 18, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X E-06784 MS
Pharmacist 183500000X 15787 LA Primary

Addresses

Primary practice location

5093 Hardy St
Hattiesburg, MS 39402

Mailing address

155 Cross Creek Pkwy Apt 531
Hattiesburg, MS 39402-4426
Phone (504) 458-0073

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
15787LAMDPharmacist
E-06784MSMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co Past Accepting new patients
Walgreen Co Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1397779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397779200000",
    "number": "1649690587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 CROSS CREEK PKWY APT 531",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394024426",
            "telephone_number": "504-458-0073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5093 HARDY ST",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "39402",
            "telephone_number": "601-579-6698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MESTAYER",
        "first_name": "JAMES",
        "middle_name": "ALLEN",
        "name_suffix": "II",
        "credential": "PHARMACIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-18",
        "last_updated": "2014-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MS",
            "license": "E-06784",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "LA",
            "license": "15787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2014; 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.