NPIMap

Organization Active NPI

McComb Og-GYN Associated

  • Specialist
  • McComb, MS
National Provider Identifier
1952411217
Registry record updated Mar 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
MCCOMB OG-GYN ASSOCIATED
Practice address
205 Marion Ave
McComb, MS 39648-2705
Phone
(601) 684-9116
Fax
(601) 684-9126
NPI assigned
Aug 30, 2006
Last updated
Mar 6, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2008

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

Authorized official

Name
Mr. David B Remely, M.D.
Title
Physician
Phone
(601) 684-9116

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NU Primary

Addresses

Primary practice location

205 Marion Ave
McComb, MS 39648-2705

Mailing address

PO Box 1348
McComb, MS 39649-1348
Phone (601) 684-9116

Other identifiers 2

IdentifierTypeStateIssuer
CJ3236OtherMSRAILROAD MEDICARE
09015836MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060320000329 MS Part B Supplier - Clinic/Group Practice 6103833959 Receives reassigned benefits from 5 practitioners
Practice locations: McComb, MS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204761600000",
    "number": "1952411217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1348",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396491348",
            "telephone_number": "601-684-9116",
            "fax_number": "601-684-9126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 MARION AVE",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396482705",
            "telephone_number": "601-684-9116",
            "fax_number": "601-684-9126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCCOMB OG-GYN ASSOCIATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2008-03-06",
        "status": "A",
        "authorized_official_last_name": "REMELY",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "601-684-9116",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CJ3236",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09015836",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McComb, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.