NPIMap

Organization Active NPI

Urology Clinic of Meridian, P.a.

  • Urology Physician
  • Meridian, MS
National Provider Identifier
1912088295
Registry record updated Apr 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
11068 Issued in MS
Legal business name
UROLOGY CLINIC OF MERIDIAN, P.A.
Practice address
1302 20TH Ave
Meridian, MS 39301-4120
Phone
(601) 693-1055
Fax
(601) 482-5312
NPI assigned
Oct 17, 2006
Last updated
Apr 9, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2008

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

Authorized official

Name
Dr. Mark T Phillips, M.D.NPI 1821124728
Title
Owner
Phone
(601) 693-1055

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 11068 MS Primary

Addresses

Primary practice location

1302 20TH Ave
Meridian, MS 39301-4120

Mailing address

1302 20TH Ave
Meridian, MS 39301-4120
Phone (601) 693-1055

Other identifiers 1

IdentifierTypeStateIssuer
08536025MedicaidMS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 159

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.

View all 159

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207699200000",
    "number": "1912088295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1302 20TH AVE",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393014120",
            "telephone_number": "601-693-1055",
            "fax_number": "601-482-5312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1302 20TH AVE",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393014120",
            "telephone_number": "601-693-1055",
            "fax_number": "601-482-5312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UROLOGY CLINIC OF MERIDIAN, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2008-04-09",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-693-1055",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MS",
            "license": "11068",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08536025",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2008; 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.