Active NPI
Neighborhood Healthcare Providers
- Internal Medicine Physician
- Hattiesburg, MS
National Provider Identifier
1700830494
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 17488
- Legal business name
- NEIGHBORHOOD HEALTHCARE PROVIDERS
- Practice address
- 2503 Glendale Ave
Hattiesburg, MS 39401-1073 - Phone
- (601) 582-5805
- Fax
- (601) 582-5806
- NPI assigned
- May 19, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Akwasi A Amponsah, MD
- Title
- Ceo
- Phone
- (601) 582-5805
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 17488 | MS | Primary |
| Internal Medicine Physician | 207R00000X | 14600 | MS | |
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | 14600 | MS | |
| Nuclear Cardiology Physician | 207UN0901X | 14600 | MS | |
| Public Health & General Preventive Medicine Physician | 2083P0901X | 17488 | MS |
Addresses
Primary practice location
2503 Glendale Ave
Hattiesburg, MS 39401-1073
Mailing address
PO Box 15613
Hattiesburg, MS 39404-5613
Phone (601) 582-5805
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00125127 | Medicaid | MS |
National Provider Directory
National Provider DirectoryLocations
500 Katie Ave
Hattiesburg, MS 39401
Phone (601) 450-4189
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147996800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1376438400000",
"number": "1700830494",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 15613",
"city": "HATTIESBURG",
"state": "MS",
"postal_code": "394045613",
"telephone_number": "601-582-5805",
"fax_number": "601-582-5806"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2503 GLENDALE AVE",
"city": "HATTIESBURG",
"state": "MS",
"postal_code": "394011073",
"telephone_number": "601-582-5805",
"fax_number": "601-582-5806"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NEIGHBORHOOD HEALTHCARE PROVIDERS",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-19",
"last_updated": "2013-08-14",
"status": "A",
"authorized_official_last_name": "AMPONSAH",
"authorized_official_first_name": "AKWASI",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "601-582-5805",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": "MS",
"license": "17488",
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": "MS",
"license": "14600",
"primary": false
},
{
"code": "207RC0200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Critical Care Medicine",
"state": "MS",
"license": "14600",
"primary": false
},
{
"code": "207UN0901X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nuclear Medicine, Nuclear Cardiology",
"state": "MS",
"license": "14600",
"primary": false
},
{
"code": "2083P0901X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Preventive Medicine, Public Health & General Preventive Medicine",
"state": "MS",
"license": "17488",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00125127",
"state": "MS"
}
],
"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 Aug 14, 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.