Active NPI
Clara Ann Myers, M.D.
- Rheumatology Physician
- Jackson, MS
National Provider Identifier
1780779306
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rheumatology Physician
- License
- 08780
- Practice address
- 971 Lakeland Drive
Suite 1157
Jackson, MS 39216 - Phone
- (601) 362-6900
- Fax
- (601) 362-6111
- NPI assigned
- Oct 3, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Rheumatology Physician | 207RR0500X | 08780 | MS | Primary |
Addresses
Primary practice location
971 Lakeland Drive
Suite 1157
Jackson, MS 39216
Mailing address
971 Lakeland Drive
Suite 1157
Jackson, MS 39216
Phone (601) 362-6900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00118847 | Medicaid | MS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MS
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070424000376 | MS | Practitioner - Rheumatology | 0042315830 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 08780 | MS | MD | Rheumatology Physician |
| R576867 | MS | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1780779306",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "971 LAKELAND DRIVE",
"address_2": "SUITE 1157",
"city": "JACKSON",
"state": "MS",
"postal_code": "39216",
"telephone_number": "601-362-6900",
"fax_number": "601-362-6111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "971 LAKELAND DRIVE",
"address_2": "SUITE 1157",
"city": "JACKSON",
"state": "MS",
"postal_code": "39216",
"telephone_number": "601-362-6900",
"fax_number": "601-362-6111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MYERS",
"first_name": "CLARA",
"middle_name": "ANN",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-03",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "207RR0500X",
"taxonomy_group": "",
"desc": "Internal Medicine, Rheumatology",
"state": "MS",
"license": "08780",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00118847",
"state": "MS"
}
],
"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 9, 2007; 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.