Individual provider Active NPI

William Truly, MD

  • General Practice Physician
  • Canton, MS
National Provider Identifier
1780893602
Registry record updated Jun 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
066123 Issued in MS
Practice address
East Peace St
Canton, MS 39046-1069
Phone
(601) 829-0018
Fax
(601) 829-0944
NPI assigned
May 21, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 066123 MS Primary

Addresses

Primary practice location

East Peace St
Canton, MS 39046-1069

Mailing address

PO Box 1069
Canton, MS 39046-1069
Phone (601) 829-0018

Other identifiers 1

IdentifierTypeStateIssuer
00019961MedicaidMS

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050609000226 MS Practitioner - Emergency MedicinePractitioner - Family PracticePractitioner - General PracticePractitioner - Internal Medicine 3072556133 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
066123MSMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson County Hospital CurrentSince Oct 24, 2018 Accepting new patients
Jefferson County Hospital CurrentSince Oct 24, 2018 Accepting new patients
Boa Vida Hospital of Aberdeen, Ms, LLC CurrentSince Jun 1, 2019 Accepting new patients
Boa Vida Hospital of Aberdeen, Ms LLC CurrentSince Jun 1, 2019 Accepting new patients
Truly Healthcare Systems CurrentSince Mar 1, 2020 Accepting new patients
Patients Choice Medical Center of Humphreys County, LLC Past Accepting new patients
Jefferson County Nursing Home Past Accepting new patients

Locations

400 S Chestnut St
Aberdeen, MS 39730
Phone (662) 369-2455

259 W Peace St
Canton, MS 39046
Phone (601) 691-5175

870 Main St
Fayette, MS 39069
Phone (601) 786-3401

3613 Hospital St
Pascagoula, MS 39581
Phone (228) 471-5217

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/13136/brand/1/csg/1/fhir/r4
  • Direct secure messaging: william.truly.1@13136.direct.athenahealth.com
  • Direct secure messaging: william.truly.2@13136.direct.athenahealth.com

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403049600000",
    "number": "1780893602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1069",
            "city": "CANTON",
            "state": "MS",
            "postal_code": "390461069",
            "telephone_number": "601-829-0018",
            "fax_number": "601-829-0944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "EAST PEACE ST",
            "city": "CANTON",
            "state": "MS",
            "postal_code": "390461069",
            "telephone_number": "601-829-0018",
            "fax_number": "601-829-0944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRULY",
        "first_name": "WILLIAM",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-21",
        "last_updated": "2014-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MS",
            "license": "066123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00019961",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, MS

Sources for this page

Verify at the official NPI Registry.