NPIMap

Hattiesburg Clinic PA

Organization Active NPI Family Medicine Physician · Hattiesburg, MS

NPI 1720188030 · NPPES record last updated Feb 22, 2021

Key facts

NPI
1720188030
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
HATTIESBURG CLINIC PA
Practice address
7148 US Highway 98
Suite101
Hattiesburg, MS 39402-8446
Phone
(601) 226-1150
Fax
(601) 296-7549
NPI assigned
Sep 25, 2006
Organization subpart
No

Authorized official

Name
Dr. Bryan N Batson, MD
Title
Executive Director
Phone
(601) 264-6000

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
25D0954468Bellevue Family Medicine
7148 US Hwy 98 Ste 101, Hattiesburg, MS 39402		ComplianceSep 21, 2026

National Provider Directory

Tax ID family
Hattiesburg Clinic PA (136 organizations share this tax ID)

Locations

7148 U S Highway 98
Ste 101
Hattiesburg, MS 39402
Phone (601) 226-1150

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207Q00000X Yes

Addresses

Primary practice location

7148 US Highway 98
Suite101
Hattiesburg, MS 39402-8446

Mailing address

415 S 28TH Ave
Hattiesburg, MS 39401-7246
Phone (601) 579-5463

Other identifiers

IdentifierTypeStateIssuer
05657575MedicaidMS

Other names

  • Bellevue Family Medicine Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 22, 2021.

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613952000000",
    "number": "1720188030",
    "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": "601-579-5463",
            "fax_number": "601-579-5240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7148 US HIGHWAY 98",
            "address_2": "SUITE101",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394028446",
            "telephone_number": "601-226-1150",
            "fax_number": "601-296-7549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HATTIESBURG CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2021-02-22",
        "certification_date": "2021-02-22",
        "status": "A",
        "authorized_official_last_name": "BATSON",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "601-264-6000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05657575",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bellevue Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bellevue Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hattiesburg, MS

All providers in Hattiesburg, MS · Family Medicine Physician in Mississippi

Sources for this page

Verify at the official NPI Registry.