Individual provider Active NPI

Michael Harris Barron, NP-C

  • Family Nurse Practitioner
  • Baldwyn, MS
National Provider Identifier
1972006419
Registry record updated Apr 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
902420 Issued in MS
Practice address
1031 Northridge Rd
Baldwyn, MS 38824-1173
Phone
(662) 365-9305
NPI assigned
Mar 12, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 902420 MS Primary

Addresses

Primary practice location

1031 Northridge Rd
Baldwyn, MS 38824-1173

Mailing address

1031 Northridge Rd
Baldwyn, MS 38824-1173
Phone (662) 365-9305

Other practice location 1

353 Highway 15 N
Pontotoc, MS 38863-1103
Phone (662) 490-1985

Other identifiers 1

IdentifierTypeStateIssuer
06434705MedicaidMS

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180328000882 MS Practitioner - Nurse Practitioner 7911269188 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
May accept Medicare assignment
Group practices
Physicians Urgent Care of CorinthGroup PAC ID 5991832081, 10 clinicians
Nursemed LLCGroup PAC ID 5294646782, 9 clinicians

Practice addresses (Care Compare)

1002 N 2ND St
Booneville, MS 38829-1314
Phone (662) 340-4375

1031 Northridge Rd
Baldwyn, MS 38824-1173
Phone (662) 365-9305

716 S Main St
Ripley, MS 38663-2909
Phone (662) 837-1534

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
902420MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Emergency Physicians LLC CurrentSince Sep 1, 2021 Accepting new patients

Locations

200 State Highway 30 W
New Albany, MS 38652
Phone (601) 534-7631

7601 Southcrest Pkwy
Southaven, MS 38671
Phone (662) 349-4000

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.

NPI Registry JSON

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

{
    "created_epoch": "1520812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619654400000",
    "number": "1972006419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1031 NORTHRIDGE RD",
            "city": "BALDWYN",
            "state": "MS",
            "postal_code": "388241173",
            "telephone_number": "662-365-9305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1031 NORTHRIDGE RD",
            "city": "BALDWYN",
            "state": "MS",
            "postal_code": "388241173",
            "telephone_number": "662-365-9305"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "353 Highway 15 N",
            "address_purpose": "LOCATION",
            "city": "Pontotoc",
            "state": "MS",
            "postal_code": "388631103",
            "country_code": "US",
            "telephone_number": "662-490-1985",
            "fax_number": "662-490-1989",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARRON",
        "first_name": "MICHAEL",
        "middle_name": "HARRIS",
        "name_prefix": "Mr.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-12",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "902420",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06434705",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baldwyn, MS

Sources for this page

Verify at the official NPI Registry.