NPIMap

Individual provider Active NPI

Abram T Coppage IV, M.D.

  • Clinical Pathology/Laboratory Medicine Physician
  • Greenwood, MS
National Provider Identifier
1518007459
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Pathology/Laboratory Medicine PhysicianTaxonomy code 207ZP0105X
License
18762 Issued in MS
Practice address
1401 River Rd
Greenwood, MS 38930-4030
Phone
(662) 459-2613
Fax
(662) 459-1159
NPI assigned
Feb 8, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

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
Clinical Pathology/Laboratory Medicine Physician 207ZP0105X 18762 MS Primary

Addresses

Primary practice location

1401 River Rd
Greenwood, MS 38930-4030

Mailing address

PO Box 1410
Greenwood, MS 38935-1410
Phone (662) 459-2613

Other identifiers 2

IdentifierTypeStateIssuer
09015650MedicaidMS
01252723MedicaidMS

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
I20050413000503 MS Practitioner - Pathology 6507803384 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Mercer University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hub Care Pathology, P.a.Group PAC ID 3173616240, 10 clinicians

Practice addresses (Care Compare)

1026 N Flowood Dr
MH Womans
Flowood, MS 39232-9532
Phone (601) 932-1000

1030 River Oaks Dr
Flowood, MS 39232-9553
Phone (601) 936-2390

161 River Oaks Dr
Canton, MS 39046-5375
Phone (601) 855-4000

1850 Chadwick Dr
Jackson, MS 39204-3404
Phone (601) 376-1000

350 Crossgates Blvd
Brandon, MS 39042-2601
Phone (601) 825-2811

5052 W 4TH St
Hattiesburg, MS 39402-1069
Phone (601) 261-2587

54 Sergeant Prentiss Dr
MH Natchez
Natchez, MS 39120-4726
Phone (601) 443-2666

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
68.13 of 100Reported as group
Quality
36.48
Improvement activities
40
Cost
76.9

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sunder Jagwani MD PA Current Accepting new patients
Hub Care Pathology, P.a. CurrentSince Apr 15, 2024 Accepting new patients
Central Mississippi Radiology Current Accepting new patients
Ocmulgee Medical Pathology Association, Inc Past Accepting new patients

Locations

1401 River Rd
Greenwood, MS 38930
Phone (662) 459-2603

5052 W 4th St
Hattiesburg, MS 39402
Phone (601) 261-2587

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1518007459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1410",
            "city": "GREENWOOD",
            "state": "MS",
            "postal_code": "389351410",
            "telephone_number": "662-459-2613",
            "fax_number": "662-459-1159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 RIVER RD",
            "city": "GREENWOOD",
            "state": "MS",
            "postal_code": "389304030",
            "telephone_number": "662-459-2613",
            "fax_number": "662-459-1159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COPPAGE",
        "first_name": "ABRAM",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0105X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "MS",
            "license": "18762",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09015650",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01252723",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, MS

Sources for this page

Verify at the official NPI Registry.