Matthew David Huckaby, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

24709 Issued in MS

Practice address

969 Lakeland Drive
Emergency Department
Jackson, MS 39216

Phone

(601) 200-6175

Fax

(601) 200-2020

NPI assigned

Apr 9, 2014

Last updated

Jun 8, 2020By 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 3

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

Specialty

Emergency Medicine

Education

Medical University of South Carolina College of Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Olive Branch Emergency Physicians LLCGroup PAC ID 9335598739, 27 clinicians

Magnolia Physician Services IncGroup PAC ID 5193912889, 10 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Magnolia Regional Health Center Hospital, Corinth, MS, CCN 250009
• Methodist Healthcare - Olive Branch Hospital Hospital, Olive Branch, MS, CCN 250167

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-usa.unify.chbase.com/org/tippah-ba3c06de
• Direct secure messaging: mhuckaby45255@mlh.direct-ci.com

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.

• Magnolia Physician Services, Inc

  • Internal Medicine Physician
  • Corinth, MS
  • NPI 1073827549
  Medicare reassignment Care Compare group NPD
• Olive Branch Emergency Physicians LLC

  • Emergency Medicine Physician
  • Olive Branch, MS
  • NPI 1730969734
  Medicare reassignment Care Compare group NPD
• Tippah County Hospital

  dba Tippah County Health Clinic

  • Primary Care Clinic/Center
  • Ripley, MS
  • NPI 1215710967
  Medicare reassignment NPD
• United Emergency Services, Inc.

  • Emergency Medicine Physician
  • Booneville, MS
  • NPI 1326007915
  Medicare reassignment NPD
• Carr PLLC

  dba Sound Physicians Emergency of Greater Memphis

  • Emergency Medicine Physician
  • Brentwood, TN
  • NPI 1548677610

  MS

  Medicare reassignment NPD
• Magnolia Ear Nose & Throat

  • Otolaryngology Physician
  • Corinth, MS
  • NPI 1881132124
  NPD
• Tippah County Hospital

  dba Tippah Care Walnut

  • Family Medicine Physician
  • Walnut, MS
  • NPI 1124823521
  NPD
• Tippah County Hospital

  dba Tippah County Health Services

  • Diagnostic Radiology Physician
  • Ripley, MS
  • NPI 1891720009
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Magnolia Regional Health Center

  • General Acute Care Hospital
  • Corinth, MS
  • NPI 1699756445
  Care Compare affiliation
• Methodist Healthcare - Olive Branch Hospital

  • General Acute Care Hospital
  • Olive Branch, MS
  • NPI 1912341439
  Care Compare affiliation

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

{
    "created_epoch": "1397001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591574400000",
    "number": "1194144824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23457",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392253457",
            "telephone_number": "601-200-6175",
            "fax_number": "601-200-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "969 LAKELAND DRIVE",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39216",
            "telephone_number": "601-200-6175",
            "fax_number": "601-200-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUCKABY",
        "first_name": "MATTHEW",
        "middle_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-09",
        "last_updated": "2020-06-08",
        "certification_date": "2020-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "MD.208248",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MS",
            "license": "24709",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08627073",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Denice Maxine Hubbard, PM HMP-BC
• Elena Nicole Hubbard, PHARMD
• Latonya Hubbard
• Chadwick Paul Huckabay, M.D.
• Sabrina Christine Huckabay, DDS
• Jarrod Huckleby
• Cathy Jo Huddleston, PHARMD
• Foster Lee Hudsmith, DDS
• Alicyn Hudson, PHARMD
• Amber Evatte Hudson, LPC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2020; 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.