Active NPI
Samuel E. Fleming III, PH.D.
- Psychologist
- Tupelo, MS
National Provider Identifier
1285614370
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 46805
- Practice address
- 211 N Madison St
Tupelo, MS 38804-3807 - Phone
- (662) 844-9003
- Fax
- (662) 844-9304
- NPI assigned
- Jan 17, 2006
- Last updated
- Sep 11, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | 661 | AL | |
| Psychologist | 103T00000X | 46805 | MS | Primary |
Addresses
Primary practice location
211 N Madison St
Tupelo, MS 38804-3807
Mailing address
211 N Madison St
Tupelo, MS 38804-3807
Phone (662) 844-9003
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01854707 | Medicaid | MS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 46805 | MS | MD | Psychologist |
| 661 | AL | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Psychnet Systems | Past | Accepting new patients | |
| Complete Family Care, LLC | Past | Accepting new patients |
Interoperability endpoints
- https://api.platform.athenahealth.com/22045/brand/1/csg/1/fhir/r4
Organizations & group practices 2
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.
-
- Family Medicine Physician
- Gadsden, AL
- NPI 1467797803
-
- Clinical Psychologist
- Birmingham, AL
- NPI 1336168467
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137456000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1285614370",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "211 N MADISON ST",
"city": "TUPELO",
"state": "MS",
"postal_code": "388043807",
"telephone_number": "662-844-9003",
"fax_number": "662-844-9304"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "211 N MADISON ST",
"city": "TUPELO",
"state": "MS",
"postal_code": "388043807",
"telephone_number": "662-844-9003",
"fax_number": "662-844-9304"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLEMING",
"first_name": "SAMUEL",
"middle_name": "E.",
"name_prefix": "Mr.",
"name_suffix": "III",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-17",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "AL",
"license": "661",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MS",
"license": "46805",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01854707",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tupelo, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.