Individual provider Active NPI

Michael Hancock, M.D.

  • Internal Medicine Physician
  • Booneville, MS
National Provider Identifier
1104236504
Registry record updated Sep 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
24955 Issued in MS
Practice address
202 N 1St St
Booneville, MS 38829-2718
Phone
(662) 340-1138
Fax
(662) 728-5185
NPI assigned
May 7, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 24955 MS Primary

Addresses

Primary practice location

202 N 1St St
Booneville, MS 38829-2718

Mailing address

350 N Humphreys Blvd
Memphis, TN 38120-2177
Phone (901) 226-4003

Other practice location 1

100 Hospital ST
Booneville, MS 38829-3354
Phone (662) 538-2110

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, AL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20171003004168 MS Practitioner - Internal Medicine 8729350301 Reassigns benefits to 2 organizations
I20220325000129 AL Practitioner - Internal Medicine 8729350301 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Tennessee, HSC, College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Ms Internal Medicine PCGroup PAC ID 6507843356, 6 clinicians

Practice addresses (Care Compare)

100 Hospital St
Booneville, MS 38829-3354
Phone (662) 538-2535

106 10TH Ave NW
Red Bay, AL 35582-3800
Phone (844) 653-0321

202 N 1St St
Suite a
Booneville, MS 38829-2718
Phone (662) 340-1138

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24955MSMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Ms Internal Medicine PC Internal Medicine CurrentSince Aug 28, 2017 Accepting new patients
Baptist Memorial Medical Group Inc Internal Medicine CurrentSince Oct 1, 2025 Accepting new patients
Hancock Internal Medicine Services, LLC Internal Medicine CurrentSince Feb 8, 2022 Accepting new patients
Baptist Memorial Medical Group Inc CurrentSince Oct 1, 2025 Accepting new patients
Baptist Memorial Health Services, Inc. of Mississippi Internal Medicine Past Accepting new patients
Generations of Red Bay, LLC Past Accepting new patients
Generations of Vernon, LLC Past Accepting new patients
Medplus Urgent Clinic LLC Past Accepting new patients

Locations

106 10th Ave NW
Red Bay, AL 35582
Phone (256) 356-4982

202 N 1st St
Booneville, MS 38829
Phone (662) 340-1138

202 N 1st St
Ste A
Booneville, MS 38829
Phone (662) 340-1138

100 Hospital St
Booneville, MS 38829
Phone (662) 720-5000

369 Highway 72
Burnsville, MS 38833
Phone (662) 279-2077

255 Baptist Blvd
Ste 301
Columbus, MS 39705
Phone (662) 244-2288

350 N Humphreys Blvd
Memphis, TN 38120
Phone (901) 226-4003

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BBJABD

Organizations & group practices 8

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.

Hospital & facility affiliations 4

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": "1399420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759190400000",
    "number": "1104236504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 N HUMPHREYS BLVD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381202177",
            "telephone_number": "901-226-4003",
            "fax_number": "901-227-8591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 N 1ST ST",
            "city": "BOONEVILLE",
            "state": "MS",
            "postal_code": "388292718",
            "telephone_number": "662-340-1138",
            "fax_number": "662-728-5185"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Hospital ST",
            "address_purpose": "LOCATION",
            "city": "Booneville",
            "state": "MS",
            "postal_code": "388293354",
            "country_code": "US",
            "telephone_number": "662-538-2110",
            "fax_number": "662-538-2593",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HANCOCK",
        "first_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-07",
        "last_updated": "2025-09-30",
        "certification_date": "2025-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "24955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Booneville, MS

Sources for this page

Verify at the official NPI Registry.