NPIMap

Individual provider Active NPI

Brian Scott Archer, MD

  • Emergency Medicine Physician
  • Hattiesburg, MS
National Provider Identifier
1902834690
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
13769 Issued in MS
Practice address
6051 Highway 49
Hattiesburg, MS 39401-7200
Phone
(601) 288-7000
NPI assigned
Jun 29, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 13769 MS Primary

Addresses

Primary practice location

6051 Highway 49
Hattiesburg, MS 39401-7200

Mailing address

186 Tidewater Rd
Hattiesburg, MS 39402-7923
Phone (601) 288-2190

Other identifiers 1

IdentifierTypeStateIssuer
00113217MedicaidMS

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
I20100719000722 MS Practitioner - Internal MedicinePractitioner - Emergency Medicine 5799817268 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Emergency Medicine
Education
Northeastern Ohio University College of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Relias Emergency Medicine Specialists of Tupelo LLCGroup PAC ID 6608179734, 39 clinicians

Practice addresses (Care Compare)

830 S Gloster St
Tupelo, MS 38801-4934
Phone (662) 377-3000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21585ALMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Forrest County General Hospital CurrentSince Apr 8, 1994 Accepting new patients
Keystone Medical Services of Ms, Inc Emergency Medicine CurrentSince Dec 6, 2012 Accepting new patients
Forrest County General Hospital Current Accepting new patients
North Mississippi Medical Center Current Accepting new patients
Relias Emergency Medicine Specialists of Hattiesburg LLC Emergency Medicine CurrentSince Apr 1, 2020 Accepting new patients
Forrest County General Hospital Emergency Medicine CurrentSince Apr 8, 1994 Accepting new patients
Pontotoc Health Services, Inc. CurrentSince May 24, 2019 Accepting new patients
Webster Health Services, Inc. CurrentSince Apr 1, 2020 Accepting new patients
Relias Emergency Medicine Specialists of Tupelo LLC Emergency Medicine CurrentSince Jan 1, 2016 Accepting new patients
Webster Health Services, Inc. CurrentSince Apr 1, 2020 Accepting new patients
Pontotoc Health Services, Inc. CurrentSince May 24, 2019 Accepting new patients
Relias Hospitalist Medicine Specialists of Pontotoc LLC CurrentSince Jan 1, 2025 Accepting new patients
Webster Health Services, Inc. Current Accepting new patients

Locations

1560 Sumrall Rd
Columbia, MS 39429
Phone (601) 736-6303

70 Medical Plz
Eupora, MS 39744
Phone (662) 258-6221

6051 U S Highway 49
Hattiesburg, MS 39401
Phone (601) 288-2690

176 S Main St
Pontotoc, MS 38863
Phone (601) 489-5510

830 S Gloster St
Tupelo, MS 38801
Phone (662) 377-3136

Interoperability endpoints

  • Direct secure messaging: brianarcher@nmhs.medalliesdirect.net

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 1

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": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902834690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "186 TIDEWATER RD",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394027923",
            "telephone_number": "601-288-2190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6051 HIGHWAY 49",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017200",
            "telephone_number": "601-288-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARCHER",
        "first_name": "BRIAN",
        "middle_name": "SCOTT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MS",
            "license": "13769",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00113217",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

Verify at the official NPI Registry.