John Patterson, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

2030-83 Issued in MS

Practice address

3502 W Northside Dr
Jackson, MS 39213-4454

Phone

(601) 362-5321

Fax

(601) 364-2600

NPI assigned

Jun 15, 2006

Last updated

Dec 20, 2007By 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 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Central Mississippi Civic Improvement Association, Inc

  dba Jackson Hinds Comprehensiv Health Center

  • Federally Qualified Health Center (FQHC)
  • Jackson, MS
  • NPI 1134151442
  Medicare reassignment NPD
• Central Mississippi Civic Improvement Association, Inc

  dba Jackson Hinds Comprehensive Health Center

  • Federally Qualified Health Center (FQHC)
  • Vicksburg, MS
  • NPI 1932145539
  NPD
• Central Mississippi Civic Improvement Association, Inc.

  dba Jackson Hinds Comprehensive Health Center Unit 7

  • Federally Qualified Health Center (FQHC)
  • Jackson, MS
  • NPI 1215744396
  NPD

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198108800000",
    "number": "1710921135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3502 W NORTHSIDE DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392134454",
            "telephone_number": "601-362-5321",
            "fax_number": "601-364-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3502 W NORTHSIDE DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392134454",
            "telephone_number": "601-362-5321",
            "fax_number": "601-364-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTERSON",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2007-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MS",
            "license": "2030-83",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00060027",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patients Choice Community Mental Health Center (Patients Choice Health Care)
• Carlos Saul Patino, MD
• Brady Clifton-Lee Patrick
• Katherine B Patrick
• Attica J Patterson, MS,MS,PCMHT
• Kevin Patterson Sr., FNP-C
• Lacey Brooke Patterson, CRNA
• Rosanna Roberts Patterson, RPH
• Ruth W Patterson, M.D.
• Shalonda Patterson

• Dentist in Jackson, MS
• Providers in Jackson, MS by specialty
• Dentist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.