Individual provider Active NPI

Thomas Allen Ligon III, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Oxford, MS
National Provider Identifier
1902980402
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
OS-367-03 Issued in MS
Practice address
1121 Mimosa Dr
Oxford, MS 38655-5101
Phone
(662) 236-5300
Fax
(662) 236-5580
NPI assigned
Oct 24, 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
Oral and Maxillofacial Surgery (Dentist) 1223S0112X OS-367-03 MS Primary

Addresses

Primary practice location

1121 Mimosa Dr
Oxford, MS 38655-5101

Mailing address

1121 Mimosa Dr
Oxford, MS 38655-5101
Phone (662) 236-5300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190606000620 MS Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 8325040991

Care Compare profile

Medicare Care Compare
Specialty
Oral Surgery
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Select Outpatient Services IncGroup PAC ID 4082868815, 750 clinicians
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians

Practice addresses (Care Compare)

2600 Compass Rd
Glenview, IL 60026-8001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OS-367-03MSMDOral and Maxillofacial Surgery (Dentist)

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902980402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 MIMOSA DR",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386555101",
            "telephone_number": "662-236-5300",
            "fax_number": "662-236-5580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 MIMOSA DR",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386555101",
            "telephone_number": "662-236-5300",
            "fax_number": "662-236-5580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIGON",
        "first_name": "THOMAS",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MS",
            "license": "OS-367-03",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxford, MS

Sources for this page

Verify at the official NPI Registry.