Preston McDonnell, M.D.
Individual provider Active NPI Family Medicine Physician · Hazlehurst, MS
NPI 1285863886 · NPPES record last updated Jun 29, 2012
Key facts
- NPI
- 1285863886
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- T-2221 (MS)
- Practice address
- 213 Caldwell Dr
Hazlehurst, MS 39083-2711 - Phone
- (601) 894-4661
- Fax
- (601) 894-2514
- NPI assigned
- Jul 6, 2009
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 10
Hospital & facility affiliations 8
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of Mississippi School of Medicine, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Copiah County Medical Center
Practice addresses (Care Compare)
27190 Hwy 28
Hazlehurst, MS 39083-2224
Phone (601) 574-7000
Hospital & facility affiliations
- Mississippi Homecare of Jackson
- Sta Home Health Agency of Jackson, Inc. Dba Accentcare Home Health of Jackson
- Arden of Central Mississippi, LLC
- Copiah County Medical Center
- King'S Daughters Medical Center-Brookhaven
- Mississippi Baptist Medical Center
- Copiah Living Center
- Pine Crest Guest Home Inc
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
| Removal of nail tissue | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120627000636 | MS | Practitioner - Family Practice | 9739344672 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| T-2221 | MS | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Copiah County Medical Center | Current | Accepting new patients | |
| Copiah County Medical Center | Family Medicine | Current |
Accepting new patients |
| Copiah County Medical Center | Current |
Accepting new patients | |
| Copiah County Medical Center | Family Medicine | Current |
Accepting new patients |
| Lima Memorial Joint Operating Company | Past | Accepting new patients | |
| Hardy Wilson Memorial Hospital | Past | Accepting new patients | |
| Copiah Community Care Center LLC | Past | Accepting new patients | |
| Pinecrest LLC | Past | Accepting new patients |
Locations
123 Bo Bo Dr
Crystal Springs, MS 39059
Phone (601) 892-2225
27190 Highway 28
Hazlehurst, MS 39083
Phone (601) 574-7000
133 Pine St
Hazlehurst, MS 39083
Phone (601) 894-1411
213 Caldwell Dr
Hazlehurst, MS 39083
Phone (601) 892-2225
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | T-2221 | MS | Yes |
Addresses
Primary practice location
213 Caldwell Dr
Hazlehurst, MS 39083-2711
Mailing address
213 Caldwell Dr
Hazlehurst, MS 39083-2711
Phone (601) 894-4661
Other providers in Hazlehurst, MS
- Kayla Elise Massey
- Remonica Shanta McBride
- Lashisna McClendon
- Glenda Neighbors McConnell
- Fred J McDonnell
- Elizabeth McKinley
- Medicomp, Inc
- Jason Dean Miles
- Chandra M. Minor
- Mississippi Eye Care of Hazlehurst
All providers in Hazlehurst, MS · Family Medicine Physician in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 29, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.