Individual provider Active NPI

Nathan Ward Baldwin, MD

  • Internal Medicine Physician
  • Booneville, MS
National Provider Identifier
1235279688
Registry record updated Aug 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
15031 Issued in MS
Practice address
100 Hospital St
Suite 100
Booneville, MS 38829-3354
Phone
(662) 720-1600
Fax
(662) 720-1664
NPI assigned
Feb 7, 2007
Last updated
Aug 30, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 15031 MS
Internal Medicine Physician 207R00000X 15031 MS Primary
Pediatrics Physician 208000000X 15031 MS

Addresses

Primary practice location

100 Hospital St
Suite 100
Booneville, MS 38829-3354

Mailing address

PO Box 70
Booneville, MS 38829-0070
Phone (662) 720-1600

Other identifiers 1

IdentifierTypeStateIssuer
00117392MedicaidMS

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
I20050114000515 MS Practitioner - Internal Medicine 6800845041 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Tennessee, HSC, College of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

100 Hospital St
Suite 100
Booneville, MS 38829-3354
Phone (662) 720-1600

PO Box
Suite 70
Booneville, MS 38829

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15031MSMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nathan W Baldwin MD PA Internal Medicine CurrentSince Jan 1, 2005 Accepting new patients

Locations

100 Hospital St
Ste 100
Booneville, MS 38829
Phone (662) 720-1600

Organizations & group practices 1

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 4

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": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1235279688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70",
            "city": "BOONEVILLE",
            "state": "MS",
            "postal_code": "388290070",
            "telephone_number": "662-720-1600",
            "fax_number": "662-720-1664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL ST",
            "address_2": "SUITE 100",
            "city": "BOONEVILLE",
            "state": "MS",
            "postal_code": "388293354",
            "telephone_number": "662-720-1600",
            "fax_number": "662-720-1664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALDWIN",
        "first_name": "NATHAN",
        "middle_name": "WARD",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-07",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "15031",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "15031",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MS",
            "license": "15031",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00117392",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Booneville, MS

Sources for this page

Verify at the official NPI Registry.