Individual provider Active NPI

John Wayne Cheatham, D.O.

  • Family Medicine Physician
  • Meridian, MS
National Provider Identifier
1497728778
Registry record updated Feb 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
18926 Issued in MS
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

Updated by the provider on Feb 18, 2019

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 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

IdentifierTypeStateIssuer
04720872MedicaidMS

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
I20050701000746 MS Practitioner - Family PracticePractitioner - Emergency Medicine 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 31 clinicians

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 Hospital, Quitman, MS, CCN 251316

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18926MSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rush Medical Foundation Family Medicine Current Accepting new patients
Rush Medical Foundation CurrentSince Aug 1, 2025 Accepting new patients
Medical Services of Meridian, Inc. CurrentSince Feb 15, 2019 Accepting new patients
Rush Medical Foundation CurrentSince Aug 1, 2025 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.