Individual provider Active NPI

Matthew D McClain, MD

  • Family Medicine Physician
  • Hattiesburg, MS
National Provider Identifier
1962517276
Registry record updated Jul 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
15971 Issued in MS
Practice address
4209 Lincoln Road
Hattiesburg, MS 39402
Phone
(601) 579-5400
Fax
(601) 261-3521
NPI assigned
Aug 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 15971 MS Primary

Addresses

Primary practice location

4209 Lincoln Road
Hattiesburg, MS 39402

Mailing address

415 S 28TH Ave
Hattiesburg, MS 39401-7246
Phone (601) 579-5400

Other identifiers 2

IdentifierTypeStateIssuer
00124695MedicaidMS
1559161OtherMSAMERICAN ADMIN GROUP

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dmcclain2156@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
I20080103000594 MS Practitioner - Family Practice 8628158664 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Mississippi School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hattiesburg Clinic PAGroup PAC ID 5193706794, 525 clinicians

Practice addresses (Care Compare)

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

Hospital & facility affiliations

  • Forrest General Home Care Home health agency, Hattiesburg, MS, CCN 257127
  • Forrest General Hospital Hospital, Hattiesburg, MS, CCN 250078

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15971MSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hattiesburg Clinic, PA CurrentSince Jun 8, 2000 Accepting new patients
Hattiesburg Clinic PA CurrentSince Jun 8, 2000 Accepting new patients
State of Mississippi - University of Mississippi Medical Center Past Accepting new patients
Hattiesburg Clinic, PA Past Accepting new patients

Locations

105 Thornhill Dr
Hattiesburg, MS 39402
Phone (601) 261-3737

5909 U S Highway 49
Ste 20
Hattiesburg, MS 39402
Phone (601) 261-1533

415 S 28th Ave
Ste 6C
Hattiesburg, MS 39401

415 S 28th Ave
Hattiesburg, MS 39401
Phone (601) 261-3606

1 Lincoln Pkwy
Ste 302
Hattiesburg, MS 39402
Phone (601) 268-5620

4209 Lincoln Rd
Hattiesburg, MS 39402
Phone (601) 579-5400

50 Parkway Ln
Ste 100
Petal, MS 39465
Phone (601) 705-2897

Interoperability endpoints

  • Direct secure messaging: dmcclain2156@directpatientrecord.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594684800000",
    "number": "1962517276",
    "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": "601-579-5400",
            "fax_number": "601-579-5240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4209 LINCOLN ROAD",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "39402",
            "telephone_number": "601-579-5400",
            "fax_number": "601-261-3521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLAIN",
        "first_name": "MATTHEW",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2020-07-14",
        "certification_date": "2020-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "15971",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00124695",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN ADMIN GROUP",
            "identifier": "1559161",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dmcclain2156@directpatientrecord.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "4209 Lincoln Road",
            "city": "Hattiesburg",
            "state": "MS",
            "country_code": "US",
            "postal_code": "39402",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

Verify at the official NPI Registry.