Samuel Keith Box, D.O.
Individual provider Active NPI Family Medicine Physician · Oxford, MS
NPI 1396973863 · NPPES record last updated May 2, 2023
Key facts
- NPI
- 1396973863
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 20944 (MS)
- Practice address
- 2173 S Lamar Blvd
Oxford, MS 38655-5223 - Phone
- (662) 234-6553
- NPI assigned
- Jun 23, 2009
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 11
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of Pikeville, Kentucky College of Osteopathic Med, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Boa Vida Hospital of Aberdeen Ms LLC
Practice addresses (Care Compare)
400 S Chestnut St
Aberdeen, MS 39730-3335
Phone (662) 369-2455
502 S Chestnut St
Aberdeen, MS 39730-3337
Phone (662) 319-8844
Hospital & facility affiliations
- Centerwell Home Health
- Monroe Regional Hospital
- BMH-Golden Triangle
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 |
|---|---|---|---|---|
| I20110823000260 | MS | Practitioner - Family Practice |
9032389457 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20944 | MS | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hattiesburg Clinic, PA | Current |
Accepting new patients | |
| Boa Vida Hospital of Aberdeen, Ms, LLC | Current |
Accepting new patients | |
| Hattiesburg Clinic PA | Current |
Accepting new patients | |
| Redmed, LLC | Current |
Accepting new patients | |
| Boa Vida Hospital of Aberdeen, Ms LLC | Current |
Accepting new patients | |
| Redmed, LLC | Current |
Accepting new patients | |
| Boa Vida Hospital of Aberdeen, Ms, LLC | Current |
Accepting new patients | |
| Pioneer Health Services of Monroe County, Inc | Past | Accepting new patients | |
| Boa Vida Hospital of Aberdeen, Ms, LLC | Past | Accepting new patients | |
| Boa Vida Hospital of Aberdeen, Ms, LLC | Past | Accepting new patients | |
| Boa Vida Hospital of Aberdeen, Ms, LLC | Past | Accepting new patients |
Locations
400 S Chestnut St
Aberdeen, MS 39730
Phone (662) 369-2455
2200 5th St N
Columbus, MS 39705
Phone (662) 369-2455
5192 Old Highway 11
#2
Hattiesburg, MS 39402
Phone (601) 268-0929
415 S 28th Ave
Hattiesburg, MS 39401
Phone (601) 261-3606
12 Brookes Crossing
Pontotoc, MS 38863
Phone (662) 489-4044
Interoperability endpoints
- samuel.box.1@7547.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 20944 | MS | Yes |
Addresses
Primary practice location
2173 S Lamar Blvd
Oxford, MS 38655-5223
Mailing address
PO Box 497
Augusta, AR 72006-0497
Phone (870) 347-2534
Other providers in Oxford, MS
- Anna Catherine Boudreaux
- Simone Franchelle Bourgeois
- Teri Boutin
- Victoria Gaskin Bowman
- Anita Box Thomas
- Kristi Boxx
- Daniel Lee Boyd
- Jessica Buchanan Boyd
- Brent Bozeman
- Tammara S Bradford
All providers in Oxford, 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 May 2, 2023. 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.