Individual provider Active NPI

Thomas Bennett Smith, M.D.

  • Emergency Medicine Physician
  • Jackson, MS
National Provider Identifier
1235484296
Registry record updated Jul 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
T-2603 Issued in MS
Practice address
2500 N State St
Jackson, MS 39216-4500
Phone
(601) 984-5570
NPI assigned
Jul 16, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X T-2603 MS Primary

Addresses

Primary practice location

2500 N State St
Jackson, MS 39216-4500

Mailing address

106 Coles Way
Madison, MS 39110-6880

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
I20140916002529 MS Practitioner - Emergency Medicine 5496974834 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Mississippi School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
United Emergency Services Inc.Group PAC ID 5799697272, 35 clinicians
Yazoo Emergency Group, LLCGroup PAC ID 0749511574, 19 clinicians

Practice addresses (Care Compare)

1100 Belk Blvd
Oxford, MS 38655-5242
Phone (662) 232-8100

2500 N State St
Jackson, MS 39216-4500
Phone (601) 898-4404

823 Grand Ave
Yazoo City, MS 39194-3233
Phone (662) 746-2261

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.46 of 100Reported as group
Quality
71.9
Improvement activities
40
Cost
87.09

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
T-2603MSMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Keystone Medical Services of Ms, Inc Emergency Medicine CurrentSince Nov 6, 2014 Accepting new patients
Attala Emergency Group LLC Emergency Medicine CurrentSince Sep 1, 2014 Accepting new patients
United Emergency Services, Inc. Emergency Medicine CurrentSince Apr 16, 2018 Accepting new patients
Yazoo Emergency Group, LLC Emergency Medicine CurrentSince May 2, 2020 Accepting new patients
Southeastern Emergency Physicians LLC Emergency Medicine CurrentSince Aug 1, 2022 Accepting new patients

Locations

100 Hospital St
Booneville, MS 38829
Phone (662) 720-5000

1560 Sumrall Rd
Columbia, MS 39429
Phone (601) 736-6303

220 Highway 12 W
Kosciusko, MS 39090
Phone (662) 289-4311

200 State Highway 30 W
New Albany, MS 38652
Phone (601) 534-7631

1100 Belk Blvd
Oxford, MS 38655
Phone (662) 636-1000

7601 Southcrest Pkwy
Southaven, MS 38671
Phone (662) 349-4000

823 Grand Ave
Yazoo City, MS 39194
Phone (601) 746-2261

Organizations & group practices 6

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 2

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": "1342396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342396800000",
    "number": "1235484296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 COLES WAY",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391106880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-5570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "THOMAS",
        "middle_name": "BENNETT",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-16",
        "last_updated": "2012-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MS",
            "license": "T-2603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.