Individual provider Active NPI

Bobbie B West, MD

  • Emergency Medical Services (Emergency Medicine) Physician
  • Jackson, MS
National Provider Identifier
1346285491
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
17449 Issued in MS
Practice address
1225 N State St
Jackson, MS 39202-2064
Phone
(601) 936-6001
Fax
(601) 936-4389
NPI assigned
Jun 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 17449 MS Primary

Addresses

Primary practice location

1225 N State St
Jackson, MS 39202-2064

Mailing address

PO Box 16076
Jackson, MS 39236-6076
Phone (601) 936-6001

Other identifiers 1

IdentifierTypeStateIssuer
00126769MedicaidMS

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
I20120308000487 MS Practitioner - General PracticePractitioner - Emergency Medicine 2264691336 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
University of Mississippi School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Quad Intermed Company LLCGroup PAC ID 6709245954, 42 clinicians

Practice addresses (Care Compare)

1515 Jefferson St
Laurel, MS 39440-4244
Phone (601) 425-4893

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Quad Intermed Company LLC CurrentSince Oct 21, 2023 Accepting new patients
Quad Intermed Company LLC Current Accepting new patients
Quad Intermed Company LLC CurrentSince Oct 21, 2023 Accepting new patients
Emergency Medicine Associates of Jackson Past Accepting new patients

Locations

1515 Jefferson St
Laurel, MS 39440
Phone (601) 425-4893

342 Gilchrist Dr
Pearl, MS 39208
Phone (601) 939-0700

308 Corporate Dr
Ridgeland, MS 39157
Phone (601) 898-7500

4204 Clay St
#V
Vicksburg, MS 39183
Phone (601) 619-7717

4204 Clay St
Vicksburg, MS 39183
Phone (601) 200-4560

Organizations & group practices 4

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 3

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": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1346285491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16076",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392366076",
            "telephone_number": "601-936-6001",
            "fax_number": "601-936-4389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022064",
            "telephone_number": "601-936-6001",
            "fax_number": "601-936-4389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEST",
        "first_name": "BOBBIE",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-20",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "MS",
            "license": "17449",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00126769",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.