Active NPI
Nileshkumar Kantilal Kothari, M.D.
- Internal Medicine Physician
- McComb, MS
National Provider Identifier
1871505008
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 35399-020
- Practice address
- 1308 Harrison Ave
McComb, MS 39648-2830 - Phone
- (601) 250-0965
- NPI assigned
- Aug 13, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 35399-020 | WI | Primary |
Addresses
Primary practice location
1308 Harrison Ave
McComb, MS 39648-2830
Mailing address
1308 Harrison Ave
McComb, MS 39648-2830
Phone (601) 250-0965
Other practice location 1
325 E H St
Iron Mountain, MI 49801-4760
Phone (906) 774-3300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130703000660 | WI | Order and Referring Only - Internal Medicine | 8729228218 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35399-020 | WI | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mississippi Band of Choctaw Indians | Past | Accepting new patients |
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.
-
- Nursing Facility/Intermediate Care Facility
- Choctaw, MS
- NPI 1891965612
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1558483200000",
"number": "1871505008",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1308 HARRISON AVE",
"city": "MCCOMB",
"state": "MS",
"postal_code": "396482830",
"telephone_number": "601-250-0965"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1308 HARRISON AVE",
"city": "MCCOMB",
"state": "MS",
"postal_code": "396482830",
"telephone_number": "601-250-0965"
}
],
"practiceLocations": [
{
"address_1": "325 E H St",
"address_purpose": "LOCATION",
"city": "Iron Mountain",
"state": "MI",
"postal_code": "498014760",
"country_code": "US",
"telephone_number": "906-774-3300",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KOTHARI",
"first_name": "NILESHKUMAR",
"middle_name": "KANTILAL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-13",
"last_updated": "2019-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "WI",
"license": "35399-020",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in McComb, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.