Individual provider Active NPI

Rex L Burrow Jr., MD

  • Anatomic Pathology & Clinical Pathology Physician
  • McComb, MS
National Provider Identifier
1962693796
Registry record updated Sep 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
04964 Issued in MS
Practice address
305 Rawls Dr
McComb, MS 39648-2833
Phone
(601) 684-0465
Fax
(601) 684-3031
NPI assigned
Aug 7, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Pathology/Laboratory Medicine Physician 207ZP0105X 51249 TN
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 04964 MS Primary

Addresses

Primary practice location

305 Rawls Dr
McComb, MS 39648-2833

Mailing address

8066 Walnut Run Rd
Ste 100
Cordova, TN 38018-8842
Phone (901) 252-3411

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
04964MSMDAnatomic Pathology & Clinical Pathology Physician

Interoperability endpoints

  • Direct secure messaging: rex.burrow.p1@direct.cpc.nextgenshare.com

NPI Registry JSON

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

{
    "created_epoch": "1186444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600300800000",
    "number": "1962693796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8066 WALNUT RUN RD",
            "address_2": "STE 100",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380188842",
            "telephone_number": "901-252-3411",
            "fax_number": "901-763-4305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 RAWLS DR",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396482833",
            "telephone_number": "601-684-0465",
            "fax_number": "601-684-3031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURROW",
        "first_name": "REX",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-07",
        "last_updated": "2020-09-17",
        "certification_date": "2020-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0105X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "TN",
            "license": "51249",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MS",
            "license": "04964",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Sep 17, 2020; 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.