Individual provider Active NPI

Alphonsus Ligouri Flannery, MD

  • Family Medicine Physician
  • Corinth, MS
National Provider Identifier
1104899129
Registry record updated Mar 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
07828 Issued in MS
Practice address
703 Alcorn Dr
Corinth, MS 38834-9302
Phone
(662) 284-9906
Fax
(662) 284-9908
NPI assigned
Feb 9, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 07828 MS Primary

Addresses

Primary practice location

703 Alcorn Dr
Corinth, MS 38834-9302

Mailing address

703 Alcorn Dr
Corinth, MS 38834-9302
Phone (662) 284-9906

Other identifiers 1

IdentifierTypeStateIssuer
00016221MedicaidMS

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20070712000063 MS Practitioner - Family Practice 5294835815 Reassigns benefits to 3 organizations
Practice locations: Corinth, MS

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
07828MSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Magnolia Regional Health Center Current Accepting new patients
Magnolia Primary Care CurrentSince May 2, 2023 Accepting new patients
Magnolia Regional Health Center Current Accepting new patients
Magnolia Regional Health Center Current Accepting new patients
Magnolia Hospitalist Group CurrentSince Aug 23, 2019 Accepting new patients
Magnolia Regional Health Center CurrentSince Jul 5, 2019 Accepting new patients
William G. Jackson, M.D.,P.a. Family Medicine Current Accepting new patients
Magnolia Regional Health Center CurrentSince Jul 5, 2019 Accepting new patients
Tishomingo Health Services, Inc. Past Accepting new patients
Tishomingo Health Services, Inc. Past Accepting new patients
Magnolia Surgical Group Past Accepting new patients
Magnolia Urgent Care Past Accepting new patients
Magnolia Internal Medicine Past Accepting new patients

Locations

8 Industrial Park
Burnsville, MS 38833
Phone (662) 593-7130

401 Alcorn Dr
Ste 2B
Corinth, MS 38834
Phone (662) 293-1680

703 Alcorn Dr
Ste 109
Corinth, MS 38834
Phone (662) 286-1499

611 Alcorn Dr
Corinth, MS 38834
Phone (601) 286-6961

202 Alcorn Dr
Corinth, MS 38834
Phone (662) 287-4481

Organizations & group practices 13

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 13

NPI Registry JSON

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330905600000",
    "number": "1104899129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 ALCORN DR",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388349302",
            "telephone_number": "662-284-9906",
            "fax_number": "662-284-9908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 ALCORN DR",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388349302",
            "telephone_number": "662-284-9906",
            "fax_number": "662-284-9908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLANNERY",
        "first_name": "ALPHONSUS",
        "middle_name": "LIGOURI",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-09",
        "last_updated": "2012-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "07828",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00016221",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corinth, MS

Sources for this page

Verify at the official NPI Registry.