Individual provider Active NPI

Marcus Andrew Presley, M.D.

  • Diagnostic Radiology Physician
  • Jackson, MS
National Provider Identifier
1164748091
Registry record updated Feb 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
24376 Issued in MS
Practice address
969 Lakeland Dr
Jackson, MS 39216-4606
Phone
(877) 406-2916
Fax
(601) 682-7909
NPI assigned
Apr 16, 2010
Last updated
Feb 10, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 48063 TN
Diagnostic Radiology Physician 2085R0202X 48063 TN
Diagnostic Radiology Physician 2085R0202X 24376 MS Primary

Addresses

Primary practice location

969 Lakeland Dr
Jackson, MS 39216-4606

Mailing address

PO Box 55769
Jackson, MS 39296-5769
Phone (601) 200-6162

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MS2 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
I20120329000507 TN Practitioner - Emergency Medicine 9335309269
I20160527001661 MS Practitioner - Diagnostic Radiology 9335309269 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Mississippi School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeland Radiologists P aGroup PAC ID 4183683089, 29 clinicians

Practice addresses (Care Compare)

969 Lakeland Dr
Jackson, MS 39216-4606
Phone (601) 200-2000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.58 of 100Reported as group
Quality
95
Improvement activities
40
Cost
75.31

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
48063TNMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeland Radiologists P a Diagnostic Radiology CurrentSince Jun 1, 2016 Accepting new patients
Flowood Mississippi Imaging LLC CurrentSince Aug 1, 2019 Accepting new patients
Decatur County General Hospital Past Accepting new patients

Locations

2510 Lakeland Dr
Flowood, MS 39232
Phone (601) 355-1234

294 E Layfair Dr
Flowood, MS 39232
Phone (601) 414-6520

1401 River Rd
Greenwood, MS 38930
Phone (662) 459-2603

1026 N Flowood Dr
Jackson, MS 39232
Phone (601) 932-1000

1030 River Oaks Dr
Jackson, MS 39232
Phone (601) 376-2165

969 Lakeland Dr
Jackson, MS 39216
Phone (601) 200-4644

106 Highland Way
Madison, MS 39110
Phone (601) 355-1234

215 Marion Ave
McComb, MS 39648
Phone (601) 249-1180

1065 E Broad St
Monticello, MS 39654
Phone (601) 249-1350

1001 Holland Ave
Philadelphia, MS 39350
Phone (601) 663-1200

2100 Highway 61 N
Vicksburg, MS 39183
Phone (601) 883-5001

409 Tyler Holmes Dr
Winona, MS 38967
Phone (662) 283-3060

Organizations & group practices 3

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.

Hospital & facility affiliations 5

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": "1271376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486684800000",
    "number": "1164748091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 55769",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392965769",
            "telephone_number": "601-200-6162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "969 LAKELAND DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164606",
            "telephone_number": "877-406-2916",
            "fax_number": "601-682-7909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRESLEY",
        "first_name": "MARCUS",
        "middle_name": "ANDREW",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-16",
        "last_updated": "2017-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "48063",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TN",
            "license": "48063",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MS",
            "license": "24376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.