Organization Active NPI

Children's Clinic of Oxford, P.a.

  • Pediatrics Physician
  • Oxford, MS
National Provider Identifier
1801916481
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
10280 Issued in MS
Legal business name
CHILDREN'S CLINIC OF OXFORD, P.A.
Practice address
2888 S Lamar Blvd
Oxford, MS 38655-5347
Phone
(662) 234-8286
Fax
(662) 234-6644
NPI assigned
Mar 29, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Joe Tanner Harris, M.D.NPI 1639188303
Title
Owner
Phone
(662) 234-8286

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 10280 MS Primary

Addresses

Primary practice location

2888 S Lamar Blvd
Oxford, MS 38655-5347

Mailing address

2888 S Lamar Blvd
Oxford, MS 38655-5347
Phone (662) 234-8286

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1801916481. Details of each certification follow.

Rural health clinic certification: CCN 258925

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
CHILDREN'S CLINIC OXFORD
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
May 7, 1997
Last certification
Oct 18, 2022
Ownership / control type
1B
Facility address
2888 South Lamar Blvd
Oxford, MS 38655

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1801916481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2888 S LAMAR BLVD",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386555347",
            "telephone_number": "662-234-8286",
            "fax_number": "662-234-6644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2888 S LAMAR BLVD",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386555347",
            "telephone_number": "662-234-8286",
            "fax_number": "662-234-6644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S CLINIC OF OXFORD, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "JOE",
        "authorized_official_middle_name": "TANNER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "662-234-8286",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "MS",
            "license": "10280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxford, MS

Sources for this page

Verify at the official NPI Registry.