Southern Family Medicine

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

SOUTHERN FAMILY MEDICINE

Practice address

603 S Holly Ave
Collins, MS 39428-3801

Phone

(601) 765-9393

Fax

(601) 765-9363

NPI assigned

Jun 9, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Jason Gregory Beasley, MDNPI 1508860214

Title

Owner

Phone

(601) 765-9393

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jason Gregory Beasley, M.D.

  • Family Medicine Physician
  • Collins, MS
  • NPI 1508860214
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1118275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548115200000",
    "number": "1982608691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "606 GERALD MCRANEY ST",
            "city": "COLLINS",
            "state": "MS",
            "postal_code": "394283801",
            "telephone_number": "601-765-9393",
            "fax_number": "601-765-9363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 S HOLLY AVE",
            "city": "COLLINS",
            "state": "MS",
            "postal_code": "394283801",
            "telephone_number": "601-765-9393",
            "fax_number": "601-765-9363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-09",
        "last_updated": "2019-01-22",
        "status": "A",
        "authorized_official_last_name": "BEASLEY",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "GREGORY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-765-9393",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01588261",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "25D1026870",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Southeast Mississippi Rural Health Initiative, Inc.
• Southeast Mississippi Rural Health Initiative, Inc.
• Southeast Mississippi Rural Health Initiative, Inc.
• Southeast Mississippi Rural Health Initiative, Inc.
• Southern Bone & Joint Specialists, PA
• Lacie Speed
• Felicia Taylor, LPNII
• Sharon Thompson, PCIDDT
• Brook Thornton, CMHT
• Jimmy Allen Walker, O.D.

• Medical Specialty Clinic/Center in Collins, MS
• Providers in Collins, MS by specialty
• Medical Specialty Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2019; 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.