Active NPI
John Wayne Cheatham, D.O.
- Family Medicine Physician
- Meridian, MS
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 18926
- Practice address
- 1600 22ND Ave
Meridian, MS 39301-3223 - Phone
- (601) 483-5322
- Fax
- (601) 581-2289
- NPI assigned
- Feb 8, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 18926 | MS | Primary |
Addresses
Primary practice location
1600 22ND Ave
Meridian, MS 39301-3223
Mailing address
703 Alcorn Dr Ste 109
Corinth, MS 38834-9302
Phone (662) 293-1175
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04720872 | Medicaid | MS |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050701000746 | MS | Practitioner - Family Practice | 6901799980 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Oklahoma State University College of Osteopathic Medicine, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Rush Medical Foundation
Practice addresses (Care Compare)
603 S Archusa Ave
Ochsner Health Center Quitman
Quitman, MS 39355-2331
Phone (601) 776-2123
605 S Archusa Ave
Quitman, MS 39355-2331
Phone (601) 776-6925
905 C S Frontage Rd
Meridian, MS 39301-6113
Phone (601) 482-4955
Hospital & facility affiliations
- Ochsner Watkins Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18926 | MS | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rush Medical Foundation | Family Medicine | Current | Accepting new patients |
| Rush Medical Foundation | Current | Accepting new patients | |
| Medical Services of Meridian, Inc. | Current | Accepting new patients | |
| Rush Medical Foundation | Current | Accepting new patients | |
| Northeast Arkansas Clinic, PA | Past | Accepting new patients |
Locations
2124 14th St
Meridian, MS 39301
Phone (601) 483-8811
1314 19th Ave
Meridian, MS 39301
Phone (601) 483-0011
905C S Frontage Rd
Meridian, MS 39301
Phone (601) 482-4955
603 S Archusa Ave
Quitman, MS 39355
Phone (601) 776-2123
Interoperability endpoints
- jcheatham@imc.gwaydirect.com
Organizations & group practices 9
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.
-
- Rural Health Clinic/Center
- Meridian, MS
- NPI 1811233950
-
- Critical Access Hospital
- Quitman, MS
- NPI 1912079625
-
- Rural Health Clinic/Center
- Quitman, MS
- NPI 1164773438
-
- Medicare Defined Swing Bed Hospital Unit
- Quitman, MS
- NPI 1477670966
-
- General Acute Care Hospital
- Meridian, MS
- NPI 1770543399
-
- Rural Health Clinic/Center
- Meridian, MS
- NPI 1891393435
-
- Multi-Specialty Clinic/Center
- Jonesboro, AR
- NPI 1376517177
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": "1139356800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1550448000000",
"number": "1497728778",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "703 ALCORN DR STE 109",
"city": "CORINTH",
"state": "MS",
"postal_code": "388349302",
"telephone_number": "662-293-1175",
"fax_number": "662-293-4323"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 22ND AVE",
"city": "MERIDIAN",
"state": "MS",
"postal_code": "393013223",
"telephone_number": "601-483-5322",
"fax_number": "601-581-2289"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHEATHAM",
"first_name": "JOHN",
"middle_name": "WAYNE",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-08",
"last_updated": "2019-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MS",
"license": "18926",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "04720872",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Meridian, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.