NPIMap

Individual provider Active NPI

Christopher L Mauldin, MD

  • Family Medicine Physician
  • Laurel, MS
National Provider Identifier
1902831837
Registry record updated Jul 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
12524 Issued in MS
Practice address
307 S 13TH Ave
Laurel, MS 39440-4342
Phone
(601) 649-7600
Fax
(601) 649-7628
NPI assigned
Jul 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2007

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 12524 MS Primary

Addresses

Primary practice location

307 S 13TH Ave
Laurel, MS 39440-4342

Mailing address

307 S 13TH Ave
Laurel, MS 39440-4342
Phone (601) 649-7166

Other identifiers 1

IdentifierTypeStateIssuer
00115503MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101123000230 MS Practitioner - Family Practice 0345302873 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Mississippi School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

307 S 13TH Ave
Laurel, MS 39440-4342
Phone (601) 649-7600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12524MSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Westridge Family Clinic Family Medicine CurrentSince Jul 1, 1989 Accepting new patients
CLC of Laurel, LLC PastSince Dec 31, 2025 Accepting new patients
Community Care Center of Laurel, LLC Past Accepting new patients

Locations

307 S 13th Ave
Laurel, MS 39440
Phone (601) 649-7600

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Laurelwood Community Living CenterLaurel, MS, CCN 255262 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Dec 27, 2023
Dec 31, 2025
Care Center of LaurelLaurel, MS, CCN 255095 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 2010
Jan 1, 2010
Deaconess HospiceLaurel, MS, CCN 251535 Hospice Contracted Managing Employee Mar 1, 2024

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

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.

Hospital & facility affiliations 5

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184198400000",
    "number": "1902831837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 S 13TH AVE",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394404342",
            "telephone_number": "601-649-7166",
            "fax_number": "601-649-7628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 S 13TH AVE",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394404342",
            "telephone_number": "601-649-7600",
            "fax_number": "601-649-7628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAULDIN",
        "first_name": "CHRISTOPHER",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2007-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "12524",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00115503",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MS

Sources for this page

Verify at the official NPI Registry.