Michael R Duckworth, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

07299 Issued in MS

Practice address

2225 5TH St N
Columbus, MS 39705-2211

Phone

(662) 327-0197

Fax

(662) 327-5660

NPI assigned

Mar 8, 2006

Last updated

Oct 17, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Baptist Memorial Health Services Inc of Mississippi

  • Pulmonary Disease Physician
  • Oxford, MS
  • NPI 1861723652
  NPD (past)
• Baptist Memorial Hospital - Golden Triangle Inc.

  • General Acute Care Hospital
  • Columbus, MS
  • NPI 1609830173
  NPD (past)

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192579200000",
    "number": "1083682934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2225 5TH ST N",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "397052211",
            "telephone_number": "662-327-0197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2225 5TH ST N",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "397052211",
            "telephone_number": "662-327-0197",
            "fax_number": "662-327-5660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUCKWORTH",
        "first_name": "MICHAEL",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-08",
        "last_updated": "2007-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "07299",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00121379",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Drayer Physical Therapy Institute LLC (Rehab At Work)
• Drayer Physical Therapy Institute LLC (Rehab At Work)
• Drayer Physical Therapy Mississippi LLC (Rehab At Work)
• Drayer Physical Therapy Mississippi LLC (Rehab At Work)
• Yasmeen Duarte
• Ashley Dumas, LMT
• Joyce Pendleton Dumas, LCSW
• Ashli D Dunn, C.F.N.P.
• Lauren Rosa Dunn, PA-C
• Thomas Jason Dunn, D.O.

• Internal Medicine Physician in Columbus, MS
• Providers in Columbus, MS by specialty
• Internal Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.