Active NPI
Greggory E Tharp, DMD
- Prosthodontics
- Jackson, MS
National Provider Identifier
1750403440
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- PROS-353-02
- Practice address
- 2695 Flowood Drive
Jackson, MS 39232 - Phone
- (601) 939-4100
- Fax
- (601) 939-4081
- NPI assigned
- Apr 4, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | PROS-353-02 | MS | Primary |
Addresses
Primary practice location
2695 Flowood Drive
Jackson, MS 39232
Mailing address
2695 Flowood Dr.
Flowood, MS 39232
Phone (601) 939-4100
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: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210310001490 | MS | Order and Referring Only - Dentist | 9830296995 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PROS-353-02 | MS | MD | Prosthodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Greggory E. Tharp DMD Inc | Prosthodontics | Current | Accepting new patients |
Locations
2695 Flowood Dr
Jackson, MS 39232
Phone (601) 939-4100
2695 Flowood Dr
#A
Jackson, MS 39232
Phone (601) 939-4100
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1750403440",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2695 FLOWOOD DR.",
"city": "FLOWOOD",
"state": "MS",
"postal_code": "39232",
"telephone_number": "601-939-4100",
"fax_number": "601-939-4081"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2695 FLOWOOD DRIVE",
"city": "JACKSON",
"state": "MS",
"postal_code": "39232",
"telephone_number": "601-939-4100",
"fax_number": "601-939-4081"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THARP",
"first_name": "GREGGORY",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "MS",
"license": "PROS-353-02",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jackson, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.