Individual provider Active NPI

Marilyn K McLeod, MD

  • Emergency Medicine Physician
  • Greenville, MS
National Provider Identifier
1487761151
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
14963 Issued in MS
Practice address
1400 E Union St
Greenville, MS 38703-3246
Phone
(662) 378-3783
NPI assigned
Aug 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 14963 MS Primary

Addresses

Primary practice location

1400 E Union St
Greenville, MS 38703-3246

Mailing address

PO Box 23998
Jackson, MS 39225-3998
Phone (662) 725-2749

Other identifiers 2

IdentifierTypeStateIssuer
1528013MedicaidLA
00118461MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, MO, TN3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20090210000658 VA Practitioner - Emergency Medicine 1850339987 Reassigns benefits to 1 organization
I20150203000405 MO Practitioner - Emergency Medicine 1850339987 Reassigns benefits to 1 organization
I20160831002086 TN Practitioner - Emergency Medicine 1850339987 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Mississippi School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Coverage LLCGroup PAC ID 3072412592, 761 clinicians

Practice addresses (Care Compare)

1995 Hwy 51 S
Covington, TN 38019-3635
Phone (901) 476-2621

Hospital & facility affiliations

  • Baptist Memorial Hospital Hospital, Memphis, TN, CCN 440048
  • Baptist Memorial Hospital - Carroll County Hospital, Huntingdon, TN, CCN 440016

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14963MSMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Coverage, LLC Emergency Medicine CurrentSince Jul 1, 2014 Accepting new patients
Southeastern Emergency Physicians LLC Emergency Medicine CurrentSince Aug 1, 2016 Accepting new patients
Southeastern Emergency Physicians of Memphis LLC Emergency Medicine CurrentSince Feb 1, 2015 Accepting new patients
Delta Medical Group Emergency Medicine Past Accepting new patients
Delta Physician Practices Past Accepting new patients
Utica Emergency Physicians, PC Emergency Medicine Past Accepting new patients
Centra Medical Group Southside, LLC Past Accepting new patients
Delta Health System Past Accepting new patients

Locations

1600 E Broadway
Columbia, MO 65201
Phone (573) 632-5000

1995 Highway 51 S
Covington, TN 38019
Phone (901) 476-2621

9352 Park West Blvd
Knoxville, TN 37923
Phone (865) 373-1000

1607 S Locust Ave
Lawrenceburg, TN 38464
Phone (731) 287-2244

Organizations & group practices 8

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 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": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487761151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23998",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392253998",
            "telephone_number": "662-725-2749",
            "fax_number": "662-725-2741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 E UNION ST",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "387033246",
            "telephone_number": "662-378-3783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLEOD",
        "first_name": "MARILYN",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MS",
            "license": "14963",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1528013",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00118461",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, MS

Sources for this page

Verify at the official NPI Registry.