Charles R. Purdy, M.D.
Individual provider Active NPI Family Medicine Physician · Meridian, MS
NPI 1992773675 · NPPES record last updated Dec 30, 2024
Key facts
- NPI
- 1992773675
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 18829 (MS)
- Practice address
- 1523 22ND Ave Ste B
Meridian, MS 39301-4016 - Phone
- (601) 703-8450
- Fax
- (601) 553-6308
- NPI assigned
- Mar 9, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 8
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Emergency Medicine
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Medical Services of Meridian Inc
Bear Creek Emergency Group LLC
Practice addresses (Care Compare)
2124 14TH St
Meridian, MS 39301-4040
Phone (601) 553-6000
Hospital & facility affiliations
- Anderson Regional Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050420001412 | MS | Practitioner - Emergency Medicine |
2264417203 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18829 | MS | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anderson Regional Medical Center | Current |
Accepting new patients | |
| Medical Services of Meridian, Inc. | Emergency Medicine | Current |
Accepting new patients |
| Anderson Regional Medical Center | Current | Accepting new patients | |
| Anderson Regional Medical Center | Current |
Accepting new patients | |
| Keystone Medical Services of Ms, Inc | Emergency Medicine | Current |
Accepting new patients |
| Bear Creek Emergency Group LLC | Emergency Medicine | Current |
Accepting new patients |
| McLemore Emergency Physicians | Emergency Medicine | Past |
Accepting new patients |
| Hope-Hempstead Emegency Group LLC | Emergency Medicine | Past | Accepting new patients |
Locations
1560 Sumrall Rd
Columbia, MS 39429
Phone (601) 736-6303
83A Old Mill Creek Rd
Enterprise, MS 39330
Phone (601) 704-1020
1102 Constitution Ave
Meridian, MS 39301
Phone (601) 693-2511
2124 14th St
Meridian, MS 39301
Phone (601) 483-8811
1600 22nd Ave
#3
Meridian, MS 39301
Phone (601) 693-1055
1523 22nd Ave
#B
Meridian, MS 39301
Phone (601) 483-0039
2024 15th St
Fl 5
Meridian, MS 39301
Phone (601) 553-6399
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 18829 | MS | |
| Family Medicine Physician | 207Q00000X | 18829 | MS | Yes |
Addresses
Primary practice location
1523 22ND Ave Ste B
Meridian, MS 39301-4016
Mailing address
965 Ridge Lake Blvd Ste 315
Memphis, TN 38120-9401
Phone (773) 348-1281
Other practice location 1
83 Old Mill Creek Rd
Enterprise, MS 39330-9649
Phone (601) 704-1020
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 07375770 | Medicaid | MS |
Other providers in Meridian, MS
- Connie O Pruitt
- Richard Pryor
- Psychology Associates, LLC
- Janet D Pugh
- Sandra H. Pupa
- James John Purdy
- Edwin M Purvis
- Ronnye Dale Purvis
- Queen City Medical Equipment, Inc
- Queen City Nursing Center Inc
All providers in Meridian, MS · Family Medicine Physician in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 30, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.