NPIMap

Individual provider Active NPI

Jack Q Causey II, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Gulfport, MS
National Provider Identifier
1790777142
Registry record updated Nov 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
11872 Issued in MS
Practice address
4500 13TH St
Gulfport, MS 39501-2515
Phone
(228) 867-4000
Fax
(228) 575-2380
NPI assigned
Aug 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 11872 MS Primary
Specialist 174400000X 11872 MS

Addresses

Primary practice location

4500 13TH St
Gulfport, MS 39501-2515

Mailing address

19648 Champion Cir
Gulfport, MS 39503-7668
Phone (601) 865-3653

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061128000465 MS Practitioner - Pathology 5294733382 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Mississippi School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Coast Pathology Services LTDGroup PAC ID 3476550872, 3 clinicians

Practice addresses (Care Compare)

4500 13TH St
Gulfport, MS 39501-2515
Phone (228) 867-4000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.5 of 100Reported as group
Quality
71
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
South Coast Pathology Services LTD Specialist CurrentSince Oct 1, 2006 Accepting new patients

Locations

15200 Community Rd
Gulfport, MS 39503
Phone (228) 575-7000

4500 13th St
Gulfport, MS 39501
Phone (228) 236-3872

5700 Southwyck Blvd
Toledo, OH 43614

Interoperability endpoints

  • Direct secure messaging: jcausey@direct.mhg.com

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 and National Provider Directory roles.

Hospital & facility affiliations 64

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 64

NPI Registry JSON

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

{
    "created_epoch": "1124496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194393600000",
    "number": "1790777142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19648 CHAMPION CIR",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395037668",
            "telephone_number": "601-865-3653",
            "fax_number": "228-575-2380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 13TH ST",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395012515",
            "telephone_number": "228-867-4000",
            "fax_number": "228-575-2380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAUSEY",
        "first_name": "JACK",
        "middle_name": "Q",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-20",
        "last_updated": "2007-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MS",
            "license": "11872",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MS",
            "license": "11872",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulfport, MS

Sources for this page

Verify at the official NPI Registry.