Thomas P Forks, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

12215 Issued in MS

Practice address

7275 S Siwell Rd
Jackson, MS 39272-9776

Phone

(601) 373-7722

Fax

(601) 373-7378

NPI assigned

Mar 8, 2006

Last updated

Dec 2, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 8

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

Merit-based Incentive Payment System (MIPS)

Final score

81.39 of 100Reported as group

Quality

65.98

Improvement activities

40

Cost

74.48

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, 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.

• Mississippi Baptist Medical Center, Inc.

  dba MS Bapitst Medical Center Geri-Psych Unit

  • Psychiatric Hospital Unit
  • Jackson, MS
  • NPI 1417984360
  NPD (past)
• Mississippi State Hospital at Whitfield

  dba Mississippi State Hospital Community Services Mental Health

  • Mental Illness Community Based Residential Treatment Facility
  • Jackson, MS
  • NPI 1336224179
  NPD (past)
• State of Mississippi - University of Mississippi Medical Center

  • Prosthetic/Orthotic Supplier
  • Jackson, MS
  • NPI 1235019530
  NPD (past)
• State of Mississippi-University of Mississippi Medical Center

  • Nurse Practitioner
  • Jackson, MS
  • NPI 1699857433
  NPD (past)
• University Family Medicine Associates, PLLC

  • Clinic/Center
  • Jackson, MS
  • NPI 1396846648
  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": "1291248000000",
    "number": "1164499190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1151 N STATE ST",
            "address_2": "SUITE 408",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022407",
            "telephone_number": "601-292-4261",
            "fax_number": "601-292-4262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7275 S SIWELL RD",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392729776",
            "telephone_number": "601-373-7722",
            "fax_number": "601-373-7378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORKS",
        "first_name": "THOMAS",
        "middle_name": "P",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-08",
        "last_updated": "2010-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "12215",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4253992",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "1ST CHOICE",
            "identifier": "753068151",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MS HEALTH PARTNERS",
            "identifier": "753068151",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00138501",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00119587",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF LABOR",
            "identifier": "168390702",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "753068151008",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MS PHYSICIANS CARE NETWOR",
            "identifier": "753068151",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Nichols Foreman, A-GNP-C
• Forest Avenue Opco, LLC (Pine Forest Health and Rehabilitation)
• Forest Hill Nursing Center, Inc.
• Ashley Lynne Forester, M.ED
• Tamika Forkner, RD, LD
• Akeelein Forrest
• Amy Forsythe, N.P.
• Christian R Fortenberry, FNP
• Deborah Fortenberry, L.H.I.S
• Faith Fortenberry, DO

• Family Medicine Physician in Jackson, MS
• Providers in Jackson, MS by specialty
• Family Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2010; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.