Individual provider Active NPI

Craig Andrew Thieling, M.D.

  • Interventional Cardiology Physician
  • Hattiesburg, MS
National Provider Identifier
1952409609
Registry record updated Jul 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
20214 Issued in MS
Practice address
415 S 28TH Ave
Hattiesburg, MS 39401-7246
Phone
(601) 268-5800
Fax
(601) 261-3530
NPI assigned
Sep 20, 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 20214 MS
Interventional Cardiology Physician 207RI0011X 20214 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 2

IdentifierTypeStateIssuer
9152189OtherMSAETNA
00937715MedicaidMS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cthieling3206@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: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080804000338 MS Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 0244258556 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
University of Mississippi School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hattiesburg Clinic PAGroup PAC ID 5193706794, 525 clinicians
Forrest County General HospitalGroup PAC ID 1052397767, 107 clinicians

Practice addresses (Care Compare)

101 Weems St
The Family Clinic of Purvis
Purvis, MS 39475-4062
Phone (601) 794-2224

1014 Rose St
Prentiss, MS 39474-5271
Phone (601) 792-2071

102 Shelby Speights Dr
Purvis, MS 39475-4151
Phone (601) 794-8065

104 Millsaps Dr
Hattiesburg, MS 39402-1328
Phone (601) 268-7500

1101 B S 28TH Ave
Dept of Podiatry
Hattiesburg, MS 39402-2610
Phone (601) 579-5117

1238 Hwy 42
Sumrall, MS 39482-9519
Phone (601) 758-3100

1240 Hwy 42
Sumrall, MS 39482-9519
Phone (601) 264-6000

15 Orleans Dr
Hattiesburg, MS 39402-8675
Phone (601) 579-5050

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

201 A Bay Ave
Richton, MS 39476-9671
Phone (601) 583-1559

215 Bobby Beasley St
Seminary, MS 39479-5501
Phone (601) 722-4300

2313 Highway15
Immediate Care Laurel
Laurel, MS 39440-1805
Phone (601) 649-2775

2313 Hwy 15 N
Laurel Family Medicine
Laurel, MS 39440-1805
Phone (601) 264-6000

301 S 28TH Ave
Hattiesburg, MS 39401-7233
Phone (601) 264-6000

360 Simpson Hwy 149
Suite 150
Magee, MS 39111-3846
Phone (601) 721-1828

415 S 28TH Ave
Hattiesburg, MS 39401-7246

415 S 28TH Ave 3Rd Floor
Ambulatory Cardiovascular Center of Mississ
Hattiesburg, MS 39401-7246
Phone (601) 268-1734

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

4209 Lincoln Rd
Hattiesburg, MS 39402-3065
Phone (601) 264-6000

50 Pkwy LN
Petal, MS 39465-3035
Phone (601) 264-6000

502 Broad St
Columbia, MS 39429-3037
Phone (601) 736-8282

5192 Old Hwy 11
Suite 2
Hattiesburg, MS 39402-6222
Phone (601) 264-6000

6051 U S Hwy 49
Forrest General Hospital
Hattiesburg, MS 39401-7200
Phone (601) 264-6000

6941 Hwy 11
Suite a
Carriere, MS 39426-7794
Phone (601) 264-6000

704 S 5TH St
Collins Family Practice Clinic
Collins, MS 39428-4147
Phone (601) 765-4414

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting26
Pacemaker insertion or repair1-10
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20214MSMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Forrest County General Hospital CurrentSince Apr 26, 2017 Accepting new patients
FGH Physician Billing Cardiovascular Disease CurrentSince Jul 9, 2008 Accepting new patients
Magee Benevolent Association Current 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 CurrentSince Apr 26, 2017 Accepting new patients
Forrest County General Hospital Current Accepting new patients
South Central Regional Medical Center CurrentSince Jul 22, 2021 Accepting new patients
South Central Regional Medical Center CurrentSince Jul 22, 2021 Accepting new patients
Hattiesburg Clinic PA CurrentSince Jul 1, 2008 Accepting new patients
Hattiesburg Clinic, PA CurrentSince Jul 1, 2008 Accepting new patients
Forrest County General Hospital Past Accepting new patients
Hattiesburg Clinic, PA 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

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

Organizations & group practices 13

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 13

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595376000000",
    "number": "1952409609",
    "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": "THIELING",
        "first_name": "CRAIG",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "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": "20214",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "MS",
            "license": "20214",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9152189",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00937715",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cthieling3206@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.