One provider matched this Medicaid ID.
Mississippi Medicaid ID 005356007 resolves to a single NPI record. Open the full profile for complete detail.
Secondary identifiers
Additional identifiers this provider has registered with NPPES. Used by medical billers, credentialers, and insurance verifiers to cross-reference claims and enrollments.
Medicaid
Source: NPPES public registry.
Medicare enrollment
This provider holds 8 Medicare enrollments on file with the Provider Enrollment, Chain and Ownership System (PECOS). Each enrollment carries a public Medicare Enrollment ID (ENRLMT_ID) used by billers and intermediaries.
Practitioner
- I20220727004157Internal MedicineMS
- I20250226003800Internal MedicineLA
- I20250228003173Internal MedicineAL
- I20250301000150Geriatric MedicineMI
- I20250303002680Internal MedicineTN
- I20250313001015Internal MedicineGA
- I20250319002222Geriatric MedicineOH
- I20260115002806Internal MedicineWV
Source: CMS PECOS public enrollment file.
ReferenceAbout state Medicaid identifiers
State Medicaid programmes assign each enrolled provider a state-scoped identifier used on Medicaid claims. The identifier is reported to the federal NPPES registry alongside the provider's NPI and is mirrored here from the public dissemination file. Each state administers its own Medicaid programme, so the same provider can hold different Medicaid numbers in different states.