NPIMap

Organization Active NPI

Comprehensive Family Medical Center, LLC

  • Family Medicine Physician
  • Horn Lake, MS
National Provider Identifier
1871863233
Registry record updated Jan 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
18992 Issued in MS
Legal business name
COMPREHENSIVE FAMILY MEDICAL CENTER, LLC
Practice address
3040 Goodman Rd W
Horn Lake, MS 38637-1189
Phone
(662) 280-3428
Fax
(662) 280-1736
NPI assigned
Jan 3, 2012
Last updated
Jan 3, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2012

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

Authorized official

Name
Barry Politi, M.D.
Title
Owner
Phone
(662) 280-3428

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 18992 MS Primary

Addresses

Primary practice location

3040 Goodman Rd W
Horn Lake, MS 38637-1189

Mailing address

3040 Goodman Rd W
Horn Lake, MS 38637-1189
Phone (662) 280-3428

Other identifiers 1

IdentifierTypeStateIssuer
1104813625OtherMSCOMMERCIAL

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1325548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325548800000",
    "number": "1871863233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3040 GOODMAN RD W",
            "city": "HORN LAKE",
            "state": "MS",
            "postal_code": "386371189",
            "telephone_number": "662-280-3428",
            "fax_number": "662-280-1736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3040 GOODMAN RD W",
            "city": "HORN LAKE",
            "state": "MS",
            "postal_code": "386371189",
            "telephone_number": "662-280-3428",
            "fax_number": "662-280-1736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPREHENSIVE FAMILY MEDICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-03",
        "last_updated": "2012-01-03",
        "status": "A",
        "authorized_official_last_name": "POLITI",
        "authorized_official_first_name": "BARRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "662-280-3428",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "18992",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL",
            "identifier": "1104813625",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Horn Lake, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.