NPIMap

Individual provider Active NPI

Bryan Barksdale, MD

  • Cardiovascular Disease Physician
  • Jackson, MS
National Provider Identifier
1083663876
Registry record updated Apr 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
06380 Issued in MS
Practice address
2500 N State St
Dept of Medicine/Division of Cardiology
Jackson, MS 39216-4500
Phone
(601) 984-5687
Fax
(601) 984-5638
NPI assigned
May 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X 06380 MS
Cardiovascular Disease Physician 207RC0000X 06380 MS Primary

Addresses

Primary practice location

2500 N State St
Dept of Medicine/Division of Cardiology
Jackson, MS 39216-4500

Mailing address

2500 N State St
Jackson, MS 39216-4500
Phone (601) 984-5687

Other identifiers 4

IdentifierTypeStateIssuer
00115734MedicaidMS
P00615907OtherMSRAILROAD
060021371OtherMSRAILROAD MEDICARE
1587451MedicaidLA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070316000226 MS Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 3274636998 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
06380MSMDCardiovascular Disease Physician

Practice roles (10 of 11)

OrganizationSpecialtyStatusNew patients
Yalobusha General Hospital CurrentSince Aug 28, 2018 Accepting new patients
Wayne General Hospsital Interventional Cardiology CurrentSince Aug 11, 2020 Accepting new patients
Wayne General Hospital CurrentSince Aug 11, 2020 Accepting new patients
Och Professional Services CurrentSince Jul 21, 2025 Accepting new patients
Wayne General Hospital Current Accepting new patients
Yalobusha General Hospital CurrentSince Aug 28, 2018 Accepting new patients
Yalobusha General Hospital Current Accepting new patients
State of Mississippi - University of Mississippi Medical Center Current Accepting new patients
Independent Healthcare Management, Inc. PastSince Aug 15, 2021 Accepting new patients
University Physicians, PLLC Past Accepting new patients

Locations

1010 Lakeland Pl
Flowood, MS 39232
Phone (601) 815-0600

1815 Hospital Dr
Jackson, MS 39204
Phone (601) 815-4775

5903 Ridgewood Rd
Jackson, MS 39211
Phone (601) 376-2022

2500 N State St
Jackson, MS 39216
Phone (601) 815-4775

239 Bowling Green Rd
Lexington, MS 39095
Phone (662) 834-1321

400 Hospital Rd
Ste 1
Starkville, MS 39759

400 Hospital Rd
Starkville, MS 39759
Phone (662) 323-4320

604 S Main St
Water Valley, MS 38965
Phone (662) 473-1311

940 Matthew Dr
Ste 5
Waynesboro, MS 39367
Phone (601) 735-7102

950 Matthew Dr
Waynesboro, MS 39367
Phone (601) 735-5151

Networks

  • LA PPO C-SNP

Interoperability endpoints

  • Direct secure messaging: bbarksdale10801@ummc.direct-ci.com

Organizations & group practices 32

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

View all 32

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
University of Mississippi School of Medicine, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
State of Mississippi - University of Mississippi Medical Center 956 clinicians
Och Professional Services 31 clinicians

Practice addresses (Care Compare)

2500 N State St
Jackson, MS 39216-4500
Phone (601) 815-4775

400 Hospital Rd
Starkville, MS 39759-2163
Phone (662) 615-3711

Hospital & facility affiliations

  • University of Mississippi Med Center Hospital, Jackson, MS, CCN 250001
  • Merit Health Madison Hospital, Canton, MS, CCN 250038
  • S E Lackey Memorial Hospital Hospital, Forest, MS, CCN 251300
  • Choctaw Regional Medical Center Hospital, Ackerman, MS, CCN 251334

NPI Registry JSON

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554940800000",
    "number": "1083663876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-5687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "address_2": "DEPT OF MEDICINE/DIVISION OF CARDIOLOGY",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-5687",
            "fax_number": "601-984-5638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARKSDALE",
        "first_name": "BRYAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-09",
        "last_updated": "2019-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "MS",
            "license": "06380",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MS",
            "license": "06380",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00115734",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "P00615907",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "060021371",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1587451",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.