NPIMap

Individual provider Active NPI

Sydney Nichole West, MD

  • Internal Medicine Physician
  • Jackson, MS
National Provider Identifier
1255960829
Registry record updated Jun 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
30991 Issued in MS
Practice address
1200 N State St Ste 500
Jackson, MS 39202-2027
Phone
(601) 352-2273
Fax
(601) 714-3215
NPI assigned
Apr 6, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 30991 MS Primary
Internal Medicine Physician 207R00000X T-4089 MS

Addresses

Primary practice location

1200 N State St Ste 500
Jackson, MS 39202-2027

Mailing address

965 Ridge Lake Blvd Ste 315
Memphis, TN 38120-9401

Other practice location 1

2500 N State St
Jackson, MS 39216-4500
Phone (601) 984-5601

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230718004281 MS Practitioner - Internal Medicine 8426418732 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Exceed Physical Therapy, LLCGroup PAC ID 8123378338, 72 clinicians

Practice addresses (Care Compare)

1200 N State St
Jackson, MS 39202-2027

1225 N State St
Jackson, MS 39202-2064
Phone (601) 292-4261

12261 Hwy 49
Suite 1
Gulfport, MS 39503-2976
Phone (228) 265-7185

401 Baptist Dr
Suite 104
Madison, MS 39110-2010
Phone (601) 973-1504

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.38 of 100Reported as group
Quality
54.22
Promoting interoperability
100
Improvement activities
40
Cost
73.72

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
T-4089MSMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mississippi Baptist Medical Center, Inc. Current Accepting new patients
Mississippi Baptist Medical Center, Inc. CurrentSince Aug 1, 2023 Accepting new patients
Mississippi Baptist Medical Center, Inc CurrentSince Aug 1, 2023 Accepting new patients
Medical Foundation of Central Ms CurrentSince Aug 1, 2023 Accepting new patients
Medical Foundation of Central Mississippi, Inc. Internal Medicine CurrentSince Aug 1, 2023 Accepting new patients
Medical Foundation of Central Ms Inc Past Accepting new patients
BMC - Attala, LLC PastSince Jul 2, 2023 Accepting new patients

Locations

1887 Spillway Rd
Brandon, MS 39047
Phone (601) 992-5532

1200 N State St
Ste 500
Jackson, MS 39202
Phone (601) 352-2273

1225 N State St
Jackson, MS 39202
Phone (601) 292-4261

401 Baptist Dr
Ste 104
Madison, MS 39110
Phone (601) 605-2383

2173 Main St
Madison, MS 39110
Phone (601) 605-3858

965 Ridge Lake Blvd
Ste 315
Memphis, TN 38120
Phone (877) 348-1281

Organizations & group practices 8

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 9

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": "1586131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1255960829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 RIDGE LAKE BLVD STE 315",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381209401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N STATE ST STE 500",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022027",
            "telephone_number": "601-352-2273",
            "fax_number": "601-714-3215"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 N State St",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "392164500",
            "country_code": "US",
            "telephone_number": "601-984-5601",
            "fax_number": "601-984-6665",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEST",
        "first_name": "SYDNEY",
        "middle_name": "NICHOLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-06",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "30991",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "T-4089",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.