Individual provider Active NPI

Joiner Mack Haltom, M.D.

  • Diagnostic Radiology Physician
  • Ridgeland, MS
National Provider Identifier
1699888628
Registry record updated Jan 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
11729 Issued in MS
Practice address
113 W Jackson St Ste B
Ridgeland, MS 39157-2402
Phone
(601) 354-4327
Fax
(601) 360-0822
NPI assigned
Aug 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 11729 MS
Diagnostic Radiology Physician 2085R0202X 11729 MS Primary

Addresses

Primary practice location

113 W Jackson St Ste B
Ridgeland, MS 39157-2402

Mailing address

113 W Jackson St Ste B
Ridgeland, MS 39157-2402
Phone (601) 354-4327

Other identifiers 1

IdentifierTypeStateIssuer
0115705MedicaidMS

Medicare participation

Medicare enrollment files
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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070716000431 MS Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 2668572017 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
81.87 of 100Reported as group
Quality
64.75
Promoting interoperability
100
Improvement activities
40
Cost
74.81

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Radiological Group, PA Specialist CurrentSince Oct 27, 1992 Accepting new patients
Jackson Anesthesia Associates PA Past Accepting new patients

Locations

1225 N State St
Jackson, MS 39202
Phone (601) 292-4261

1225 N State St
Ste 2C
Jackson, MS 39202
Phone (601) 968-1000

113 W Jackson St
Ste B
Ridgeland, MS 39157

1107 Highland Colony Pkwy
Ste 209
Ridgeland, MS 39157
Phone (601) 360-0823

823 Grand Ave
Yazoo City, MS 39194
Phone (601) 746-2261

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737072000000",
    "number": "1699888628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 W JACKSON ST STE B",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391572402",
            "telephone_number": "601-354-4327",
            "fax_number": "601-360-0822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 W JACKSON ST STE B",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391572402",
            "telephone_number": "601-354-4327",
            "fax_number": "601-360-0822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALTOM",
        "first_name": "JOINER",
        "middle_name": "MACK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2025-01-17",
        "certification_date": "2025-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MS",
            "license": "11729",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MS",
            "license": "11729",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0115705",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgeland, MS

Sources for this page

Verify at the official NPI Registry.