James Keith Stanford II, MD
Individual provider Active NPI Otolaryngology Physician · Vicksburg, MS
NPI 1063866705 · NPPES record last updated Feb 28, 2022
Key facts
- NPI
- 1063866705
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Otolaryngology Physician 207Y00000X
- License
- T-3219 (MS)
- Practice address
- 2200 Highway 61 N Ste 2300
Vicksburg, MS 39183-8246 - Phone
- (601) 883-3320
- Fax
- (601) 883-3326
- NPI assigned
- Apr 19, 2016
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Otolaryngology
- Education
- University of Mississippi School of Medicine, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Vicksburg Clinic LLC
Practice addresses (Care Compare)
2100 Hwy 61 N
Vicksburg, MS 39183-8211
Phone (601) 883-5000
2200 Hwy 61 N
Vicksburg, MS 39183-8246
Hospital & facility affiliations
- Merit Health River Region
- University of Mississippi Medical Center- Grenada
Merit-based Incentive Payment System (MIPS)
- Final score
- 88.07 of 100
- Quality
- 73.89
- Promoting interoperability
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 1-10 |
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 |
|---|---|---|---|---|
| I20210713003784 | MS | Practitioner - Otolaryngology | 9133412976 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vicksburg Clinic LLC | Current |
Accepting new patients | |
| Vicksburg Clinic LLC | Past | Accepting new patients |
Locations
2100 Highway 61 N
Vicksburg, MS 39183
Phone (601) 883-5001
2200 Highway 61 N
Ste 2300
Vicksburg, MS 39183
Phone (601) 883-3320
104 McAuley Dr
Vicksburg, MS 39183
Phone (601) 638-7271
Interoperability endpoints
- james.stanford.1@1475.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | T-3219 | MS | Yes |
Addresses
Primary practice location
2200 Highway 61 N Ste 2300
Vicksburg, MS 39183-8246
Mailing address
PO Box 689022
Franklin, TN 37068-9022
Phone (615) 465-7361
Other practice location 1
2100 Highway 61 N
Vicksburg, MS 39183-8211
Phone (601) 883-5000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01882015 | Medicaid | MS |
Other providers in Vicksburg, MS
- Angela Spencer
- Carlie Spohn
- Rachael Spray
- Charles Stampley
- Aneshia Stamps
- Markus B Stanley
- Louis Steenkamp
- Thomas J Stelma III
- Stephanie Fay Phelan
- Lashell Steward
All providers in Vicksburg, MS · Otolaryngology 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 Feb 28, 2022. 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.