Pacific Physician Services LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

PACIFIC PHYSICIAN SERVICES LLC

Practice address

425 Highway 42
Petal, MS 39465-2891

Phone

(601) 584-4890

NPI assigned

Apr 18, 2006

Last updated

Mar 27, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Debbie T Brewer

Title

Director

Phone

(615) 465-7626

Specialties & licenses 1

Addresses

Other identifiers 6

Practitioners 8

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.

• Robert B Brahan, MD

  • Internal Medicine Physician
  • Hattiesburg, MS
  • NPI 1881608586
  NPD (past)
• Omolara Otaigbe, MD

  • Family Medicine Physician
  • Hattiesburg, MS
  • NPI 1932164456
  NPD (past)
• Bretley Todd Sitzman, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Hattiesburg, MS
  • NPI 1295845311
  NPD (past)
• Edmund Martin Bagingito, MD

  • Anesthesiology Physician
  • Port Charlotte, FL
  • NPI 1164487641
  NPD (past)
• Gordon H Clark, MD

  • Family Medicine Physician
  • Denham Springs, LA
  • NPI 1265546014
  NPD (past)
• Jonathan Adam Hodge, DO

  • Anesthesiology Physician
  • Chattanooga, TN
  • NPI 1972568954
  NPD (past)
• John F Kliesch, MD

  • Family Medicine Physician
  • Kingsport, TN
  • NPI 1679538326
  NPD (past)
• Sudha R Ravoori, M.D.

  • Anesthesiology Physician
  • Canton, GA
  • NPI 1700824224
  NPD (past)

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

{
    "created_epoch": "1145318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332806400000",
    "number": "1902861651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 MERIDIAN BLVD",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370676325",
            "telephone_number": "615-465-7626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 HIGHWAY 42",
            "city": "PETAL",
            "state": "MS",
            "postal_code": "394652891",
            "telephone_number": "601-584-4890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC PHYSICIAN SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-18",
        "last_updated": "2012-03-27",
        "status": "A",
        "authorized_official_last_name": "BREWER",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "615-465-7626"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09016137",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09016291",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05781336",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01302267",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09016153",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09270509",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie Murray, CMHT
• Ramon Monroe Napier, D.M.D.
• John Clayton Nelson, MD
• Hang My-Thi Nguyen, FNP
• Julie Pace, RD
• Paki Inc (Central Family Clinic)
• Kimberly Nicole Patrick
• Joseph J Patterson, DPT
• Robert Perez
• Petal Chiropractic Clinic, Inc.

• General Practice Physician in Petal, MS
• Providers in Petal, MS by specialty
• General Practice Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2012; 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.