Active NPI
Robert Marshall Tharp, Jr, OD, Inc
- Optometrist
- Jackson, MS
National Provider Identifier
1790858538
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- Legal business name
- ROBERT MARSHALL THARP, JR, OD, INC
- Practice address
- 6351 Interstate 55 North
Ste. 115-B
Jackson, MS 39213 - Phone
- (601) 991-9723
- Fax
- (601) 991-9745
- NPI assigned
- Nov 17, 2006
- Last updated
- May 6, 2010
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Robert Marshall Tharp Jr., O.D.
- Title
- President
- Phone
- (601) 991-9723
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | NU | Primary |
Addresses
Primary practice location
6351 Interstate 55 North
Ste. 115-B
Jackson, MS 39213
Mailing address
6351 Interstate 55 North
Ste. 115-B
Jackson, MS 39213
Phone (601) 991-9723
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 09014792 | Medicaid | MS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MS
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
6351 I 55 N
Ste 115B
Jackson, MS 39213
Phone (601) 991-9723
Practitioners & affiliated clinicians
Practitioners 2
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.
-
- Optometrist
- Jackson, MS
- NPI 1881767531
-
- Optometrist
- Jackson, MS
- NPI 1427121268
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163721600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1273104000000",
"number": "1790858538",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6351 INTERSTATE 55 NORTH",
"address_2": "STE. 115-B",
"city": "JACKSON",
"state": "MS",
"postal_code": "39213",
"telephone_number": "601-991-9723",
"fax_number": "601-991-9745"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6351 INTERSTATE 55 NORTH",
"address_2": "STE. 115-B",
"city": "JACKSON",
"state": "MS",
"postal_code": "39213",
"telephone_number": "601-991-9723",
"fax_number": "601-991-9745"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ROBERT MARSHALL THARP, JR, OD, INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-11-17",
"last_updated": "2010-05-06",
"status": "A",
"authorized_official_last_name": "THARP",
"authorized_official_first_name": "ROBERT",
"authorized_official_middle_name": "MARSHALL",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "601-991-9723",
"authorized_official_name_suffix": "Jr.",
"authorized_official_credential": "O.D."
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "09014792",
"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 May 6, 2010; 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.