Individual provider Active NPI

Phillip Jeff Barkley, DMD

  • Dentist
  • Jackson, MS
National Provider Identifier
1679635320
Registry record updated May 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
MS303398 Issued in MS
Practice address
5643 Hwy 18 South
Suite G
Jackson, MS 39209
Phone
(601) 922-0056
Fax
(601) 922-0056
NPI assigned
Dec 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X MS303398 MS Primary

Addresses

Primary practice location

5643 Hwy 18 South
Suite G
Jackson, MS 39209

Mailing address

5643 Hwy 18 South
Suite G
Jackson, MS 39209
Phone (601) 922-0056

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
MS303398MSMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399852800000",
    "number": "1679635320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5643 HWY 18 SOUTH",
            "address_2": "SUITE G",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39209",
            "telephone_number": "601-922-0056",
            "fax_number": "601-922-0056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5643 HWY 18 SOUTH",
            "address_2": "SUITE G",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39209",
            "telephone_number": "601-922-0056",
            "fax_number": "601-922-0056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARKLEY",
        "first_name": "PHILLIP",
        "middle_name": "JEFF",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-15",
        "last_updated": "2014-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MS",
            "license": "MS303398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 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.