Organization Active NPI

Shiloh Neurology PC

  • Neurology Physician
  • Corinth, MS
National Provider Identifier
1649788894
Registry record updated Dec 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
SHILOH NEUROLOGY PC
Practice address
123 Alcorn Drive
Corinth, MS 38834
Phone
(662) 594-1799
Fax
(662) 594-8621
NPI assigned
Jan 22, 2018
Last updated
Dec 31, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2018

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

Authorized official

Name
Dr. Andrew L Kerby, MDNPI 1104844505
Title
Provider/Owner
Phone
(662) 594-1799

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
Neurology Physician 2084N0400X Primary

Addresses

Primary practice location

123 Alcorn Drive
Corinth, MS 38834

Mailing address

123 Alcorn Drive
Corinth, MS 38834
Phone (662) 594-1799

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180226001811 MS Part B Supplier - Clinic/Group Practice 9032470562 Receives reassigned benefits from 1 practitioner
Practice locations: Corinth, MS

National Provider Directory

National Provider Directory

Locations

123 Alcorn Dr
Corinth, MS 38834
Phone (256) 767-7494

Practitioners & affiliated clinicians

Practitioners 1

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": "1516579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546214400000",
    "number": "1649788894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 ALCORN DRIVE",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "38834",
            "telephone_number": "662-594-1799",
            "fax_number": "662-594-8621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 ALCORN DRIVE",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "38834",
            "telephone_number": "662-594-1799",
            "fax_number": "662-594-8621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHILOH NEUROLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-22",
        "last_updated": "2018-12-31",
        "status": "A",
        "authorized_official_last_name": "KERBY",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PROVIDER/OWNER",
        "authorized_official_telephone_number": "662-594-1799",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corinth, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.