Individual provider Active NPI

Patrick Dale Whipple, M.D.

  • Family Medicine Physician
  • Jackson, MS
National Provider Identifier
1457513350
Registry record updated Jul 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
T-2115 Issued in MS
Practice address
878 Lakeland Dr
Jackson, MS 39216-4644
Phone
(601) 984-6800
Fax
(601) 984-6811
NPI assigned
Jul 1, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X T-2115 MS Primary

Addresses

Primary practice location

878 Lakeland Dr
Jackson, MS 39216-4644

Mailing address

PO Box 4999
Jackson, MS 39296-4999
Phone (601) 984-6800

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
I20100802000094 MS Practitioner - Family Practice 8123151875 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Mississippi School of Medicine, 2011
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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
T-2115MSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Quad Intermed Company LLC CurrentSince Aug 1, 2023 Accepting new patients
Mississippi State Hospital at Whitfield Current Accepting new patients
Mississippi State Hospital CurrentSince Jul 1, 2025 Accepting new patients
Quad Intermed Company LLC CurrentSince Aug 1, 2023 Accepting new patients
Mississippi State Hospital at Whitfield CurrentSince Jul 1, 2025 Accepting new patients
Quad Intermed Company LLC Family Medicine PastSince May 11, 2025 Accepting new patients
Quad Intermed Company LLC 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

3550 Highway 468 W
Whitfield, MS 39193

3550 Highway 468 W
Bldg 201
Whitfield, MS 39193
Phone (601) 351-8216

3550 Highway 468 W
#B60
Whitfield, MS 39193

3550 Highway 468 W
#B24
Whitfield, MS 39193

Organizations & group practices 7

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 1

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": "1214870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214870400000",
    "number": "1457513350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4999",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392964999",
            "telephone_number": "601-984-6800",
            "fax_number": "601-984-6811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "878 LAKELAND DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164644",
            "telephone_number": "601-984-6800",
            "fax_number": "601-984-6811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHIPPLE",
        "first_name": "PATRICK",
        "middle_name": "DALE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-01",
        "last_updated": "2008-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "T-2115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.