NPIMap

Individual provider Active NPI

Otis Gowdy Jr., M.D.

  • Nephrology Physician
  • Meridian, MS
National Provider Identifier
1992782544
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
17024 Issued in MS
Practice address
1600 22ND Ave
Medical Towers III
Meridian, MS 39301-3223
Phone
(601) 483-5322
Fax
(601) 581-2289
NPI assigned
Dec 26, 2005
Last updated
Oct 23, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 17024 MS Primary

Addresses

Primary practice location

1600 22ND Ave
Medical Towers III
Meridian, MS 39301-3223

Mailing address

PO Box 749215
Atlanta, GA 30374-9215
Phone (901) 226-3186

Other identifiers 1

IdentifierTypeStateIssuer
01281539MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050722000297 MS Practitioner - NephrologyPractitioner - Internal Medicine 3678500592 Reassigns benefits to 4 organizations
I20160128001475 TX Practitioner - NephrologyPractitioner - Internal Medicine 3678500592 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
University of South Alabama College of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anderson Physician Alliance IncGroup PAC ID 3274727318, 69 clinicians
Hospitalist Services of Meridian PAGroup PAC ID 3274818042, 41 clinicians
Dumont Physician Services LLCGroup PAC ID 6800385576, 44 clinicians

Practice addresses (Care Compare)

1600 22ND Ave
Suite a
Meridian, MS 39301-3223
Phone (601) 693-1055

2124 14TH St
Meridian, MS 39301-4040
Phone (601) 553-6000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17024MSMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mississippi Band of Choctaw Indians CurrentSince Jan 7, 2016 Accepting new patients
Mississippi Band of Choctaw Indians CurrentSince Jan 7, 2016 Accepting new patients
Mississippi Band of Choctaw Indians Current Accepting new patients
Urology Clinic of Meridian, P.a. Current Accepting new patients
Joel T Callahan Thomas H Greer Jr & a Gary Boone PTR CurrentSince Sep 1, 2005 Accepting new patients
Dumont Physician Services LLC CurrentSince Dec 2, 2025 Accepting new patients
Anderson Regional Medical Center Past Accepting new patients

Locations

210 Hospital Cir
Choctaw, MS 39350
Phone (601) 389-4500

1102 Constitution Ave
#F
Meridian, MS 39301
Phone (601) 693-2511

1102 Constitution Ave
Fl 2
Meridian, MS 39301
Phone (601) 484-7900

1600 22nd Ave
Meridian, MS 39301
Phone (601) 483-5322

1600 22nd Ave
#3
Meridian, MS 39301
Phone (601) 693-1055

2113 11th St
Fl 2
Meridian, MS 39301
Phone (601) 483-5322

2124 14th St
Meridian, MS 39301
Phone (601) 483-8811

Interoperability endpoints

  • Direct secure messaging: ogowdy@imc.directbygreenway.com
  • Direct secure messaging: ogowdy@imc.gwaydirect.com
  • Direct secure messaging: ogowdy625513@direct.bmhcc.org

Organizations & group practices 9

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

Hospital & facility affiliations 9

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": "1135555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1992782544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 749215",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303749215",
            "telephone_number": "901-226-3186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 22ND AVE",
            "address_2": "MEDICAL TOWERS III",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393013223",
            "telephone_number": "601-483-5322",
            "fax_number": "601-581-2289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOWDY",
        "first_name": "OTIS",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-26",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MS",
            "license": "17024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01281539",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, MS

Sources for this page

Verify at the official NPI Registry.