NPIMap

Organization Active NPI

Medical Foundation, Inc.

Doing business as Ochsner Rush Medical Center Emergency Room Professional Services

  • Emergency Medicine Physician
  • Meridian, MS
National Provider Identifier
1700917994
Registry record updated Apr 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
MEDICAL FOUNDATION, INC.
Doing business as
Ochsner Rush Medical Center Emergency Room Professional Services
Practice address
1314 19TH Ave
Meridian, MS 39301-4116
Phone
(601) 703-9260
Fax
(601) 703-4050
NPI assigned
Mar 8, 2007
Last updated
Apr 21, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2023

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

Authorized official

Name
Don Larkin Kennedy
Title
Regional Ceo
Phone
(601) 703-9614

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X Primary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

1314 19TH Ave
Meridian, MS 39301-4116

Mailing address

Dept 3020, P.O. Box 1000
Memphis, TN 38148-3020
Phone (601) 213-3010

Other names 1

  • Ochsner Rush Medical Center Emergency Room Professional Services Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

National Provider Directory

National Provider Directory

Locations

1 Independence Sq
Ste 1D
Butler, AL 36904
Phone (205) 459-4388

1 Independence Sq
Ste 1E
Butler, AL 36904
Phone (205) 459-5001

401 Vanity Fair Ave
Ste 2
Butler, AL 36904
Phone (601) 703-4531

14365 Highway 16 W
Ste 2
De Kalb, MS 39328
Phone (601) 703-4918

24489 Highway 80
Lake, MS 39092
Phone (601) 775-3264

1800 12th St
Meridian, MS 39301
Phone (601) 483-0011

605 S Archusa Ave
Ste 2
Quitman, MS 39355
Phone (601) 703-4918

25117 Highway 15
Ste 2
Union, MS 39365
Phone (601) 703-4918

Practitioners & affiliated clinicians

Practitioners 285

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 285

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682035200000",
    "number": "1700917994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT 3020, P.O. BOX 1000",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381483020",
            "telephone_number": "601-213-3010",
            "fax_number": "601-213-3011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1314 19TH AVE",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393014116",
            "telephone_number": "601-703-9260",
            "fax_number": "601-703-4050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL FOUNDATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2023-04-21",
        "certification_date": "2023-04-21",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "DON",
        "authorized_official_middle_name": "LARKIN",
        "authorized_official_title_or_position": "REGIONAL CEO",
        "authorized_official_telephone_number": "601-703-9614"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Ochsner Rush Medical Center Emergency Room Professional Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Meridian, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2023; 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.