NPIMap

Individual provider Active NPI

George Joshua Blair, MD

  • Interventional Cardiology Physician
  • Hattiesburg, MS
National Provider Identifier
1902835234
Registry record updated Jul 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
18584 Issued in MS
Practice address
415 S 28TH Ave
Hattiesburg, MS 39401-7246
Phone
(601) 268-5800
Fax
(601) 261-3530
NPI assigned
Jun 30, 2006
Last updated
Jul 22, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 18584 MS
Interventional Cardiology Physician 207RI0011X 18584 MS Primary

Addresses

Primary practice location

415 S 28TH Ave
Hattiesburg, MS 39401-7246

Mailing address

415 S 28TH Ave
Hattiesburg, MS 39401-7246
Phone (601) 268-5800

Other identifiers 3

IdentifierTypeStateIssuer
07989353MedicaidMS
9652063OtherMSAETNA
1332470MedicaidLA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gblair3179@directpatientrecord.com Health Information Exchange (HIE)

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
I20060824000463 MS Practitioner - Interventional CardiologyPractitioner - Internal MedicinePractitioner - Cardiovascular Disease (Cardiology) 5799788147 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
University of Mississippi School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Forrest County General HospitalGroup PAC ID 1052397767, 107 clinicians
Hattiesburg Clinic PAGroup PAC ID 5193706794, 525 clinicians
FGH Physician BillingGroup PAC ID 1850344946, 27 clinicians

Practice addresses (Care Compare)

1560 Sumrall Rd
Columbia, MS 39429-2654
Phone (601) 736-6303

415 S 28TH Ave
Hattiesburg, MS 39401-7246
Phone (601) 264-6000

6051 U S Hwy 49
Hattiesburg, MS 39401-7200
Phone (601) 288-2474

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting50
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18584MSMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Forrest County General Hospital CurrentSince Apr 30, 2017 Accepting new patients
FGH Physician Billing Cardiovascular Disease CurrentSince Aug 28, 2010 Accepting new patients
Walthall General Hospital CurrentSince Sep 25, 2011 Accepting new patients
Walthall General Hospital CurrentSince Sep 25, 2011 Accepting new patients
Forrest County General Hospital Current Accepting new patients
Forrest County General Hospital CurrentSince Apr 30, 2017 Accepting new patients
Mississippi Methodist Hospital & Rehabilitation Center, Inc. CurrentSince Aug 15, 2005 Accepting new patients
Hattiesburg Clinic PA CurrentSince Aug 24, 2007 Accepting new patients
Mississippi Methodist Hospital & Rehabilitation Center, Inc. CurrentSince Aug 15, 2005 Accepting new patients
Hattiesburg Clinic, PA CurrentSince Aug 24, 2007 Accepting new patients
Forrest County General Hospital Past Accepting new patients
Hattiesburg Clinic, PA Past Accepting new patients
Ms Methodist Hospital & Rehabilitation Center Cardiovascular Disease Past Accepting new patients
State of Mississippi - University of Mississippi Medical Center Past Accepting new patients

Locations

701 S Holly Ave
Collins, MS 39428
Phone (601) 765-3180

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

502 Broad St
Columbia, MS 39429
Phone (601) 736-8282

415 S 28th Ave
Hattiesburg, MS 39401
Phone (601) 261-3606

415 S 28th Ave
Fl 3
Hattiesburg, MS 39401
Phone (601) 268-1734

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

1350 E Woodrow Wilson Ave
Jackson, MS 39216
Phone (601) 364-5340

300 SE 3rd Ave
Magee, MS 39111
Phone (601) 849-5070

128 Highland Pkwy
Ste 200
Picayune, MS 39466
Phone (601) 358-9630

801 Goodyear Blvd
Picayune, MS 39466
Phone (601) 749-0688

1014 Rose St
Ste A
Prentiss, MS 39474
Phone (601) 792-2200

100 Hospital Dr
Tylertown, MS 39667
Phone (601) 876-0455

303 First St S
Wiggins, MS 39577
Phone (601) 928-4412

Interoperability endpoints

  • Direct secure messaging: gblair3179@directpatientrecord.com

Organizations & group practices 14

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 14

Hospital & facility affiliations 6

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": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595376000000",
    "number": "1902835234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 S 28TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017246",
            "telephone_number": "601-268-5800",
            "fax_number": "601-579-5240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 S 28TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017246",
            "telephone_number": "601-268-5800",
            "fax_number": "601-261-3530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAIR",
        "first_name": "GEORGE",
        "middle_name": "JOSHUA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2020-07-22",
        "certification_date": "2020-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MS",
            "license": "18584",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "MS",
            "license": "18584",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07989353",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9652063",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1332470",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gblair3179@directpatientrecord.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "415 S 28th Ave",
            "city": "Hattiesburg",
            "state": "MS",
            "country_code": "US",
            "postal_code": "394017246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

Verify at the official NPI Registry.