Active NPI
Richard Gray Sloan Jr., D.O.
- Neuromusculoskeletal Medicine & OMM Physician
- Hattiesburg, MS
National Provider Identifier
1669705372
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neuromusculoskeletal Medicine & OMM Physician
- License
- 22621
- Practice address
- 498 Tuscan Ave
Hattiesburg, MS 39401-5461 - Phone
- (601) 318-6098
- NPI assigned
- Sep 13, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | OS10752 | FL | |
| Neuromusculoskeletal Medicine & OMM Physician | 204D00000X | 22621 | MS | Primary |
Addresses
Primary practice location
498 Tuscan Ave
Hattiesburg, MS 39401-5461
Mailing address
498 Tuscan Ave
Hattiesburg, MS 39401-5461
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)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22621 | MS | MD | Neuromusculoskeletal Medicine & OMM Physician |
| OS10752 | FL | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1252800000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1375056000000",
"number": "1669705372",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "498 TUSCAN AVE",
"city": "HATTIESBURG",
"state": "MS",
"postal_code": "394015461"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "498 TUSCAN AVE",
"city": "HATTIESBURG",
"state": "MS",
"postal_code": "394015461",
"telephone_number": "601-318-6098"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SLOAN",
"first_name": "RICHARD",
"middle_name": "GRAY",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-09-13",
"last_updated": "2013-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "OS10752",
"primary": false
},
{
"code": "204D00000X",
"taxonomy_group": "",
"desc": "Neuromusculoskeletal Medicine & OMM",
"state": "MS",
"license": "22621",
"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 Jul 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.