Individual provider Active NPI

Stephen Todd Threadgill, M.D.

  • Gastroenterology Physician
  • Oxford, MS
National Provider Identifier
1225046543
Registry record updated Feb 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
11791 Issued in MS
Practice address
1208 Office Park Dr
Oxford, MS 38655-3597
Phone
(662) 234-9888
Fax
(662) 281-8927
NPI assigned
Aug 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 11791 MS Primary

Addresses

Primary practice location

1208 Office Park Dr
Oxford, MS 38655-3597

Mailing address

PO Box 381468
Germantown, TN 38183-1468

Other practice location 1

825 W Monroe St
Grenada, MS 38901-5042
Phone (662) 234-9888

Other practice location 2

1210 Office Park Dr
Oxford, MS 38655-3606
Phone (662) 234-9888

Other identifiers 1

IdentifierTypeStateIssuer
000112961MedicaidMS

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
I20100730000626 MS Practitioner - GastroenterologyPractitioner - Internal Medicine 9739212556 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
University of Mississippi School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gastroenterology Center of the Midsouth PLLCGroup PAC ID 4880619824, 148 clinicians

Practice addresses (Care Compare)

1208 Office Park Dr
Oxford, MS 38655-3597
Phone (662) 294-9888

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy270
Upper gastrointestinal (GI) endoscopy for acid reflux250

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
G I Diagnostic and Therapeutic Center LLC Gastroenterology Current Accepting new patients
Gastroenterology Center of the Midsouth PLLC Gastroenterology CurrentSince May 1, 2021 Accepting new patients
Hospital Authority of Jefferson County and the City of Louisville Gastroenterology Past Accepting new patients
Hospital Authority of Jefferson County and the City of Louisville Past Accepting new patients

Locations

825 W Monroe St
Ste 2
Grenada, MS 38901
Phone (662) 234-9888

1208 Office Park Dr
Oxford, MS 38655
Phone (662) 234-9888

1210 Office Park Dr
Oxford, MS 38655
Phone (662) 234-9888

7668 Airways Blvd
Bldg 2
Southaven, MS 38671
Phone (901) 766-9490

589 Garfield St
Ste 201
Tupelo, MS 38801
Phone (662) 680-5565

Organizations & group practices 4

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 1

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": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771200000000",
    "number": "1225046543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 381468",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381831468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1208 OFFICE PARK DR",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386553597",
            "telephone_number": "662-234-9888",
            "fax_number": "662-281-8927"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "825 W Monroe St",
            "address_purpose": "LOCATION",
            "city": "Grenada",
            "state": "MS",
            "postal_code": "389015042",
            "country_code": "US",
            "telephone_number": "662-234-9888",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1210 Office Park Dr",
            "address_purpose": "LOCATION",
            "city": "Oxford",
            "state": "MS",
            "postal_code": "386553606",
            "country_code": "US",
            "telephone_number": "662-234-9888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THREADGILL",
        "first_name": "STEPHEN",
        "middle_name": "TODD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2026-02-16",
        "certification_date": "2026-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MS",
            "license": "11791",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000112961",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxford, MS

Sources for this page

Verify at the official NPI Registry.