NPIMap

Individual provider Active NPI

Mary Grace Hancock, M.D.

  • Internal Medicine Physician
  • Booneville, MS
National Provider Identifier
1508253295
Registry record updated May 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25681 Issued in MS
Practice address
202 N 1St St Ste B
Booneville, MS 38829
Phone
(662) 340-1138
NPI assigned
Apr 20, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 7, 2025

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
Internal Medicine Physician 207R00000X 25681 MS Primary

Addresses

Primary practice location

202 N 1St St Ste B
Booneville, MS 38829

Mailing address

350 N Humphreys Blvd
Memphis, TN 38120-2177
Phone (901) 226-4003

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
I20181001001578 MS Practitioner - Internal Medicine 8820349848 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Tennessee, HSC, College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northeast Ms Internal Medicine PCGroup PAC ID 6507843356, 6 clinicians

Practice addresses (Care Compare)

202 N 1St St
Booneville, MS 38829-2718
Phone (662) 340-1138

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Ms Internal Medicine PC Internal Medicine CurrentSince Sep 12, 2018 Accepting new patients
Baptist Memorial Medical Group Inc CurrentSince Oct 1, 2025 Accepting new patients
Baptist Memorial Medical Group Inc Internal Medicine CurrentSince Oct 1, 2025 Accepting new patients
Baptist Memorial Health Services, Inc. of Mississippi Internal Medicine Past Accepting new patients

Locations

202 N 1st St
Booneville, MS 38829
Phone (662) 340-1138

202 N 1st St
Ste A
Booneville, MS 38829
Phone (662) 340-1138

202 N 1st St
Ste B
Booneville, MS 38829
Phone (662) 287-5218

100 Hospital St
Booneville, MS 38829
Phone (662) 720-5000

369 Highway 72
Burnsville, MS 38833
Phone (662) 279-2077

255 Baptist Blvd
Ste 301
Columbus, MS 39705
Phone (662) 244-2288

350 N Humphreys Blvd
Memphis, TN 38120
Phone (901) 226-4003

Organizations & group practices 4

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 6

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": "1429488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746576000000",
    "number": "1508253295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 N HUMPHREYS BLVD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381202177",
            "telephone_number": "901-226-4003",
            "fax_number": "901-227-8591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 N 1ST ST STE B",
            "city": "BOONEVILLE",
            "state": "MS",
            "postal_code": "38829",
            "telephone_number": "662-340-1138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANCOCK",
        "first_name": "MARY",
        "middle_name": "GRACE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-20",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "25681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Booneville, MS

Sources for this page

Verify at the official NPI Registry.