Active NPI
Highland Community Clinic Network
- Obstetrics & Gynecology Physician
- Picayune, MS
National Provider Identifier
1730310335
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 19353
- Legal business name
- HIGHLAND COMMUNITY CLINIC NETWORK
- Practice address
- 801 Goodyear Blvd
Picayune, MS 39466-3221 - Phone
- (985) 726-2655
- Fax
- (985) 643-9808
- NPI assigned
- Jul 30, 2009
- Organization subpart
- Yes
- Parent organization
- HIGHLAND COMMUNITY HOSPITAL
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Bryan N. Stevens, CPA, FHFMA
- Title
- Cfo
- Phone
- (601) 749-3121
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | |||
| Obstetrics & Gynecology Physician | 207V00000X | 19353 | MS | Primary |
Addresses
Primary practice location
801 Goodyear Blvd
Picayune, MS 39466-3221
Mailing address
1375 Corporate Square Dr
Slidell, LA 70458-3147
Phone (985) 726-2655
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DP4385 | Other | RAILROAD MCARE | |
| 03900238 | Medicaid | MS | |
| 2112015 | Medicaid | LA |
National Provider Directory
National Provider Directory- Part of
- Forrest County Gen Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1248912000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1317081600000",
"number": "1730310335",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1375 CORPORATE SQUARE DR",
"city": "SLIDELL",
"state": "LA",
"postal_code": "704583147",
"telephone_number": "985-726-2655",
"fax_number": "985-643-9808"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "801 GOODYEAR BLVD",
"city": "PICAYUNE",
"state": "MS",
"postal_code": "394663221",
"telephone_number": "985-726-2655",
"fax_number": "985-643-9808"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HIGHLAND COMMUNITY CLINIC NETWORK",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "HIGHLAND COMMUNITY HOSPITAL",
"enumeration_date": "2009-07-30",
"last_updated": "2011-09-27",
"status": "A",
"authorized_official_last_name": "STEVENS",
"authorized_official_first_name": "BRYAN",
"authorized_official_middle_name": "N.",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "601-749-3121",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "CPA, FHFMA"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Emergency Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207V00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Obstetrics & Gynecology",
"state": "MS",
"license": "19353",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MCARE",
"identifier": "DP4385",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "03900238",
"state": "MS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2112015",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Picayune, MS
- Mary Catherine Hess, FNP, APRN-BC
- Lisa Richardson Hesson, OTR-L
- Rodney D Hesson, PSYD
- Caroline Savannah Hickman
- Highland Center for Women's Health
- Highland Community Clinic Network
- Highland Community Clinic Network
- Highland Community Hospital Physicians
- Highland Emergency Physicians, PA
- Highland Health MD, PLLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.