Active NPI
Firas Mourad
- Prosthodontics
- Ridgeland, MS
National Provider Identifier
1932639077
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 6043-23
- Practice address
- 230 Trace Colony Park Dr Ste 1
Ridgeland, MS 39157-8851 - Phone
- (601) 707-3878
- NPI assigned
- Jun 12, 2017
- Last updated
- Jan 8, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | 6043-23 | MS | Primary |
Addresses
Primary practice location
230 Trace Colony Park Dr Ste 1
Ridgeland, MS 39157-8851
Mailing address
230 Trace Colony Park Dr Ste 1
Ridgeland, MS 39157-8851
Phone (601) 707-3878
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6043-23 | MS | MD | Prosthodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| State of Mississippi - University of Mississippi Medical Center | Current | Accepting new patients |
Locations
2500 N State St
Jackson, MS 39216
Phone (601) 815-4775
2500 N State St
#4200
Jackson, MS 39216
Interoperability endpoints
- fmourad126611@ummc.direct-ci.com
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.
-
- General Acute Care Hospital
- Jackson, MS
- NPI 1154317527
-
dba University Dentists
- Dentist
- Jackson, MS
- NPI 1184765372
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704672000000",
"number": "1932639077",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "230 TRACE COLONY PARK DR STE 1",
"city": "RIDGELAND",
"state": "MS",
"postal_code": "391578851",
"telephone_number": "601-707-3878"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "230 TRACE COLONY PARK DR STE 1",
"city": "RIDGELAND",
"state": "MS",
"postal_code": "391578851",
"telephone_number": "601-707-3878"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOURAD",
"first_name": "FIRAS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-06-12",
"last_updated": "2024-01-08",
"certification_date": "2024-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "MS",
"license": "6043-23",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Ridgeland, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.