Larry Ethan Milton, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

80249 Issued in MS

Practice address

502 Broad St Ste 2
Columbia, MS 39429-3037

Phone

(601) 736-8282

Fax

(601) 736-8333

NPI assigned

Apr 15, 2020

Last updated

Jan 27, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Kent State University College of Podiatric Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hattiesburg Clinic PAGroup PAC ID 5193706794, 525 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: emilton147118@directpatientrecord.com

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

• Hattiesburg Clinic PA

  • Multi-Specialty Clinic/Center
  • Hattiesburg, MS
  • NPI 1740213446
  Medicare reassignment Care Compare group NPD
• South Central Clinics, Inc

  dba Ellisville Medical Clinic

  • Family Medicine Physician
  • Ellisville, MS
  • NPI 1801226287
  Medicare reassignment NPD
• Hattiesburg Clinic, PA

  dba Podiatry - Columbia

  • Podiatrist
  • Columbia, MS
  • NPI 1902617632
  NPD
• Hattiesburg Clinic, PA

  dba Flowood Primary Care

  • Primary Care Clinic/Center
  • Flowood, MS
  • NPI 1912600354
  NPD
• South Central Cinics, Inc

  dba South Central Podiatry

  • Podiatrist
  • Laurel, MS
  • NPI 1598548042
  NPD
• South Central Clinics, Inc

  dba South Central Urgent Care

  • Rural Health Clinic/Center
  • Laurel, MS
  • NPI 1033903547
  NPD
• South Central Clinics, Inc

  dba South Central General Surgery

  • Surgery Physician
  • Laurel, MS
  • NPI 1154405413
  NPD
• South Central Clinics, Inc

  dba South Central Gastroenterology

  • Gastroenterology Physician
  • Laurel, MS
  • NPI 1346767852
  NPD
• Hattiesburg Clinic, PA

  dba Laurel Dialysis Unit

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Laurel, MS
  • NPI 1245263540
  NPD (past)
• State of Mississippi - University of Mississippi Medical Center

  dba Holmes County Hospital and Clinic

  • Critical Access Hospital
  • Lexington, MS
  • NPI 1386630705
  NPD (past)

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

{
    "created_epoch": "1586908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737936000000",
    "number": "1699394098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 S 28TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017246",
            "telephone_number": "601-264-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 BROAD ST STE 2",
            "city": "COLUMBIA",
            "state": "MS",
            "postal_code": "394293037",
            "telephone_number": "601-736-8282",
            "fax_number": "601-736-8333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10844 S Lake Gambusi Dr",
            "address_purpose": "LOCATION",
            "city": "Vail",
            "state": "AZ",
            "postal_code": "856412507",
            "country_code": "US",
            "telephone_number": "623-419-4331",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1002 Jefferson St.",
            "address_2": "Suite 400",
            "address_purpose": "LOCATION",
            "city": "Laurel",
            "state": "MS",
            "postal_code": "39440",
            "country_code": "US",
            "telephone_number": "601-649-7802",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILTON",
        "first_name": "LARRY",
        "middle_name": "ETHAN",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-15",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "211D00000X",
            "taxonomy_group": "",
            "desc": "Assistant, Podiatric",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MS",
            "license": "80249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Amanda McKenzie, FNP
• Lala McKenzie, IDD WAIVER SERVICES
• Shelley McKenzie, LMSW
• Susan Lorenda McLendon, LPN
• Med360 LLC (Med360)
• Janet Mingo
• Mississippi Pharmaceutical Services, LLC (Columbia Medical Supply)
• Mississippi State Department of Health
• Jennifer Moak
• Lillian Grace Monroe

• Podiatrist in Columbia, MS
• Providers in Columbia, MS by specialty
• Podiatrist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.