NPIMap

Organization Active NPI

Magnolia Ear Nose & Throat

  • Otolaryngology Physician
  • Corinth, MS
National Provider Identifier
1881132124
Registry record updated Jul 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
MAGNOLIA EAR NOSE & THROAT
Practice address
401 Alcorn Dr
Suite 2 D
Corinth, MS 38834
Phone
(662) 293-1565
Fax
(662) 293-4204
NPI assigned
Feb 7, 2017
Last updated
Jul 18, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
MAGNOLIA REGIONAL HEALTH CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 18, 2018

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

Authorized official

Name
Ronny Humes
Title
Ceo
Phone
(662) 293-7664

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X NU Primary

Addresses

Primary practice location

401 Alcorn Dr
Suite 2 D
Corinth, MS 38834

Mailing address

401 Alcorn Dr Ste 2C
Corinth, MS 38834-9073
Phone (662) 293-7266

Other identifiers 2

IdentifierTypeStateIssuer
583312OtherMSMS MEDICARE
07633259MedicaidMS

National Provider Directory

National Provider Directory
Part of
Magnolia Regional Healt

Locations

401 Alcorn Dr
Ste 2D
Corinth, MS 38834
Phone (662) 293-1565

Practitioners & affiliated clinicians

Practitioners 47

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.

View all 47

NPI Registry JSON

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

{
    "created_epoch": "1486425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531872000000",
    "number": "1881132124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 ALCORN DR STE 2C",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388349073",
            "telephone_number": "662-293-7266",
            "fax_number": "662-293-6255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 ALCORN DR",
            "address_2": "SUITE 2 D",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "38834",
            "telephone_number": "662-293-1565",
            "fax_number": "662-293-4204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA EAR NOSE & THROAT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MAGNOLIA REGIONAL HEALTH CENTER",
        "enumeration_date": "2017-02-07",
        "last_updated": "2018-07-18",
        "status": "A",
        "authorized_official_last_name": "HUMES",
        "authorized_official_first_name": "RONNY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "662-293-7664"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MS MEDICARE",
            "identifier": "583312",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07633259",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corinth, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2018; 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.