Active NPI
Jeffrey Wayne Carter
- Contractor
- Columbus, MS
National Provider Identifier
1902109903
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- 972770
- Practice address
- 1809 7TH Avenue North
Columbus, MS 39701 - Phone
- (662) 251-1064
- NPI assigned
- Dec 13, 2010
- Last updated
- Dec 13, 2010
- 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 |
|---|---|---|---|---|
| Contractor | 171W00000X | 972770 | MS | Primary |
Addresses
Primary practice location
1809 7TH Avenue North
Columbus, MS 39701
Mailing address
P.O.Box 8774
Columbus, MS 39701
Phone (662) 251-1064
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 972770 | Other | MS | BUSINESS ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 972770 | MS | MD | Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1292198400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1292198400000",
"number": "1902109903",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O.BOX 8774",
"city": "COLUMBUS",
"state": "MS",
"postal_code": "39701",
"telephone_number": "662-251-1064"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1809 7TH AVENUE NORTH",
"city": "COLUMBUS",
"state": "MS",
"postal_code": "39701",
"telephone_number": "662-251-1064"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARTER",
"first_name": "JEFFREY",
"middle_name": "WAYNE",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-12-13",
"last_updated": "2010-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "MS",
"license": "972770",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BUSINESS ID",
"identifier": "972770",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Columbus, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.