Individual provider Active NPI

Bridget Y Tah-Clayton, D.O.

  • Internal Medicine Physician
  • Hattiesburg, MS
National Provider Identifier
1700877537
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
16941 Issued in MS
Practice address
701 South 28TH Avenue
Suite D
Hattiesburg, MS 39401
Phone
(601) 579-3025
Fax
(601) 264-0727
NPI assigned
Nov 1, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 16941 MS Primary

Addresses

Primary practice location

701 South 28TH Avenue
Suite D
Hattiesburg, MS 39401

Mailing address

415 S 28TH Ave
Hattiesburg, MS 39401-7246
Phone (601) 579-3025

Other practice location 1

2124 14th St
Meridian, MS 39301-4040
Phone (601) 553-6000

Other practice location 2

1102 Constitution Ave
Meridian, MS 39301-4001
Phone (601) 703-5000

Other identifiers 2

IdentifierTypeStateIssuer
P00445048OtherMSRAILROAD MEDICARE
00122708MedicaidMS

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
I20061218000556 MS Practitioner - Internal Medicine 7315946449 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16941MSMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Forrest County General Hospital Current Accepting new patients
Anderson Physician Alliance, Inc. Internal Medicine CurrentSince Mar 30, 2025 Accepting new patients
Forrest County General Hospital Internal Medicine CurrentSince Oct 1, 2006 Accepting new patients
Forrest County General Hospital CurrentSince Oct 1, 2006 Accepting new patients
Urology Clinic of Meridian, P.a. Current Accepting new patients

Locations

6051 U S Highway 49
Hattiesburg, MS 39401
Phone (601) 288-2690

1102 Constitution Ave
Meridian, MS 39301
Phone (601) 693-2511

2124 14th St
Meridian, MS 39301
Phone (601) 483-8811

1600 22nd Ave
Meridian, MS 39301
Phone (601) 483-5322

Organizations & group practices 6

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": "1130803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1700877537",
    "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": "601-579-3025",
            "fax_number": "601-579-5240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 SOUTH 28TH AVENUE",
            "address_2": "SUITE D",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "39401",
            "telephone_number": "601-579-3025",
            "fax_number": "601-264-0727"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2124 14th St",
            "address_purpose": "LOCATION",
            "city": "Meridian",
            "state": "MS",
            "postal_code": "393014040",
            "country_code": "US",
            "telephone_number": "601-553-6000",
            "fax_number": "601-703-0124",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1102 Constitution Ave",
            "address_purpose": "LOCATION",
            "city": "Meridian",
            "state": "MS",
            "postal_code": "393014001",
            "country_code": "US",
            "telephone_number": "601-703-5000",
            "fax_number": "601-703-0124",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAH-CLAYTON",
        "first_name": "BRIDGET",
        "middle_name": "Y",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-01",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "16941",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00445048",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00122708",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

Verify at the official NPI Registry.