NPIMap

Organization Active NPI

Anderson Physician Alliance, Inc.

Doing business as Baptist Medical Group-Anderson Physician Alliance

  • Multi-Specialty Clinic/Center
  • Meridian, MS
National Provider Identifier
1760798227
Registry record updated Aug 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
ANDERSON PHYSICIAN ALLIANCE, INC.
Doing business as
Baptist Medical Group-Anderson Physician Alliance
Practice address
2124 14TH St
Meridian, MS 39301-4040
Phone
(601) 703-3480
Fax
(601) 703-0124
NPI assigned
Aug 23, 2010
Last updated
Aug 16, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2024

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

Authorized official

Name
Gregory M Duckett
Title
Sr VP / Clo
Phone
(901) 227-5233

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X NU
Multi-Specialty Clinic/Center 261QM1300X MS Primary
Family Medicine Physician 207Q00000X NU
Internal Medicine Physician 207R00000X NU
Urology Physician 208800000X NU

Addresses

Primary practice location

2124 14TH St
Meridian, MS 39301-4040

Mailing address

PO Box 2839
Meridian, MS 39302-2839
Phone (601) 703-3480

Other identifiers 2

IdentifierTypeStateIssuer
03604849MedicaidMS
127195MedicaidAL

Other names 1

  • Baptist Medical Group-Anderson Physician Alliance Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101102000877 MS Part B Supplier - Clinic/Group Practice 3274727318 Receives reassigned benefits from 168 practitioners
4 other NPIs on this enrollment
Practice locations: Meridian, MS; Newton, MS; Philadelphia, MS; Quitman, MS; Collinsville, MS; De Kalb, MS

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

522 E Pushmataha St
Butler, AL 36904
Phone (205) 459-4400

713 N Washington St
Livingston, AL 35470
Phone (205) 652-5778

8985 Church Rd
Collinsville, MS 39325
Phone (601) 553-2000

1020 22nd Ave
Ste D
Meridian, MS 39301
Phone (601) 553-6361

1514 23rd Ave
Meridian, MS 39301
Phone (601) 531-3969

1516 23rd Ave
Meridian, MS 39301
Phone (601) 553-6491

1521 22nd Ave
#A
Meridian, MS 39301
Phone (601) 483-2866

1600 22nd Ave
#3
Meridian, MS 39301
Phone (601) 693-1055

2024 15th St
Ste 5N
Meridian, MS 39301
Phone (601) 703-8360

4728 Highway 39 N
Meridian, MS 39301
Phone (601) 482-8151

Practitioners & affiliated clinicians

Practitioners 197

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 197

NPI Registry JSON

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

{
    "created_epoch": "1282521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723766400000",
    "number": "1760798227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2839",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393022839",
            "telephone_number": "601-703-3480",
            "fax_number": "601-703-0124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2124 14TH ST",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393014040",
            "telephone_number": "601-703-3480",
            "fax_number": "601-703-0124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDERSON PHYSICIAN ALLIANCE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-23",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A",
        "authorized_official_last_name": "DUCKETT",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SR VP / CLO",
        "authorized_official_telephone_number": "901-227-5233"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "MS",
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03604849",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "127195",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baptist Medical Group-Anderson Physician Alliance",
            "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 Aug 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.