Individual provider Active NPI

Bernard Gayle Harrell, D.O.

  • Family Medicine Physician
  • Forest, MS
National Provider Identifier
1871575852
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
10830 Issued in MS
Practice address
1080 Highway 35 S
Forest, MS 39074-9423
Phone
(601) 469-3555
Fax
(601) 469-3584
NPI assigned
Nov 16, 2005
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 10830 MS Primary

Addresses

Primary practice location

1080 Highway 35 S
Forest, MS 39074-9423

Mailing address

PO Box 5183
Meridian, MS 39302-5183
Phone (601) 703-9506

Other identifiers 2

IdentifierTypeStateIssuer
00013342MedicaidMS
010013307OtherRAILROAD MEDICARE

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
I20080729000321 MS Practitioner - Family Practice 4688748460 Reassigns benefits to 2 organizations
Practice locations: Forest, MS

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

505 Airport Rd
Suite D
Forest, MS 39074-4033
Phone (601) 333-0947

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Independent Healthcare Management, Inc. CurrentSince Jan 1, 2025 Accepting new patients
Independent Healthcare Management, Inc. CurrentSince Jul 8, 1992 Accepting new patients
Independent Healthcare Management, Inc. CurrentSince Jul 8, 1992 Accepting new patients
Independent Healthcare Management, Inc. PastSince Aug 15, 2021 Accepting new patients

Locations

330 N Broad St
Forest, MS 39074
Phone (601) 469-4151

330 N Broad St
#S
Forest, MS 39074
Phone (601) 469-4151

505 Airport Rd
Ste F
Forest, MS 39074
Phone (601) 333-0947

526 Deerfield Dr
Unit C
Forest, MS 39074
Phone (601) 469-0291

Interoperability endpoints

  • Direct secure messaging: bernard.harrell@phspch.eclinicaldirectplus.com

Organizations & group practices 4

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

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1871575852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5183",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393025183",
            "telephone_number": "601-703-9506",
            "fax_number": "601-703-3264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1080 HIGHWAY 35 S",
            "city": "FOREST",
            "state": "MS",
            "postal_code": "390749423",
            "telephone_number": "601-469-3555",
            "fax_number": "601-469-3584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRELL",
        "first_name": "BERNARD",
        "middle_name": "GAYLE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-16",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "10830",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00013342",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "010013307",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest, MS

Sources for this page

Verify at the official NPI Registry.