NPIMap

Individual provider Active NPI

William Davis, M.D.

  • Family Medicine Physician
  • Tupelo, MS
National Provider Identifier
1407237365
Registry record updated Oct 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
24691 Issued in MS
Practice address
1665 S Green St
Tupelo, MS 38804-6556
Phone
(662) 377-2189
Fax
(662) 377-2667
NPI assigned
Jun 16, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 24691 MS Primary

Addresses

Primary practice location

1665 S Green St
Tupelo, MS 38804-6556

Mailing address

401 Alcorn Dr
Ste 2C
Corinth, MS 38834-9073
Phone (662) 293-7266

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
I20180626002065 MS Practitioner - Family Practice 8224325592 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Mississippi School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Mississippi Faculty Practice Plan LLCGroup PAC ID 2961658950, 8 clinicians

Practice addresses (Care Compare)

1665 S Green St
Tupelo, MS 38804-6556
Phone (662) 377-2189

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24691MSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Harper Minor Medical Clinic, LLC Current Accepting new patients
Magnolia Regional Health Center Current Accepting new patients
North Mississippi Faculty Practice Plan LLC Family Medicine CurrentSince Jul 20, 2022 Accepting new patients
Magnolia Hospitalist Group CurrentSince Oct 20, 2019 Accepting new patients
Magnolia Regional Health Center Current Accepting new patients
Pratt Family Medical Clinic, P.a. Family Medicine CurrentSince Jul 1, 2018 Accepting new patients
Magnolia Regional Health Center Current Accepting new patients
Magnolia Regional Health Center CurrentSince Jul 1, 2018 Accepting new patients
North Mississippi Medical Center Current Accepting new patients
Magnolia Regional Health Center CurrentSince Jul 1, 2018 Accepting new patients
Premier Radiology, Inc PastSince Jul 1, 2018 Accepting new patients
North Mississippi Medical Center, Inc. Past Accepting new patients
North Mississippi Faculty Practice Family Medicine Past Accepting new patients

Locations

611 Alcorn Dr
Corinth, MS 38834
Phone (601) 286-6961

401 Alcorn Dr
Ste 2C
Corinth, MS 38834
Phone (662) 286-9255

121 Pratt Dr
#A
Corinth, MS 38834
Phone (662) 286-0088

1665 S Green St
Tupelo, MS 38804
Phone (662) 377-2189

Interoperability endpoints

  • Direct secure messaging: williamdavis@nmhs.medalliesdirect.net
  • Direct secure messaging: williamdavis@magnolia.medalliesdirect.net

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 2

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": "1434412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571097600000",
    "number": "1407237365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 ALCORN DR",
            "address_2": "STE 2C",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388349073",
            "telephone_number": "662-293-7266",
            "fax_number": "662-293-6255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1665 S GREEN ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388046556",
            "telephone_number": "662-377-2189",
            "fax_number": "662-377-2667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-16",
        "last_updated": "2019-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "24691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tupelo, MS

Sources for this page

Verify at the official NPI Registry.