NPIMap

Organization Active NPI

Pioneer Health Services of Monroe County, Inc

  • Clinic/Center
  • Aberdeen, MS
National Provider Identifier
1669724183
Registry record updated Oct 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
13-033 Issued in MS
Legal business name
PIONEER HEALTH SERVICES OF MONROE COUNTY, INC
Practice address
502 S Chestnut St
Aberdeen, MS 39730-3337
Phone
(601) 849-6440
Fax
(601) 849-1318
NPI assigned
Oct 8, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2012

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

Authorized official

Name
Mr. Joseph Sylvester McNulty III
Title
Ceo
Phone
(601) 849-6440

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 13-033 MS Primary

Addresses

Primary practice location

502 S Chestnut St
Aberdeen, MS 39730-3337

Mailing address

502 S Chestnut St
Aberdeen, MS 39730-3337
Phone (601) 849-6440

Other names 1

  • Pioneer Pediatric Clinic Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1349654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349654400000",
    "number": "1669724183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 S CHESTNUT ST",
            "city": "ABERDEEN",
            "state": "MS",
            "postal_code": "397303337",
            "telephone_number": "601-849-6440",
            "fax_number": "601-849-1318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 S CHESTNUT ST",
            "city": "ABERDEEN",
            "state": "MS",
            "postal_code": "397303337",
            "telephone_number": "601-849-6440",
            "fax_number": "601-849-1318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIONEER HEALTH SERVICES OF MONROE COUNTY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-08",
        "last_updated": "2012-10-08",
        "status": "A",
        "authorized_official_last_name": "MCNULTY",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "SYLVESTER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "601-849-6440",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MS",
            "license": "13-033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pioneer Pediatric Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Aberdeen, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2012; 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.