Individual provider Active NPI

Elizabeth Katherine Schimmel, M.D.

  • Otolaryngology Physician
  • Flowood, MS
National Provider Identifier
1558604934
Registry record updated Jun 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
30023 Issued in MS
Practice address
151 E Metro Dr Ste 102
Flowood, MS 39232-4404
Phone
(601) 973-1680
Fax
(601) 973-1681
NPI assigned
Apr 3, 2013
Last updated
Jun 3, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X MD188118 OR
Otolaryngology Physician 207Y00000X 30023 MS Primary

Addresses

Primary practice location

151 E Metro Dr Ste 102
Flowood, MS 39232-4404

Mailing address

249 Eastbrooke St
Jackson, MS 39216-4716
Phone (601) 672-4263

Other practice location 1

2222 NW Lovejoy St Ste 622
Portland, OR 97210
Phone (503) 229-8455

Other practice location 2

501 N Graham St Ste 500
Portland, OR 97227-2003
Phone (503) 229-8455

Other practice location 3

500 N Columbia River Hwy
Saint Helens, OR 97051-1299
Phone (503) 229-8455

Other identifiers 1

IdentifierTypeStateIssuer
500659886MedicaidOR

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
I20220721002330 MS Practitioner - Otolaryngology 7416190004 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Mississippi School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1225 N State St
Jackson, MS 39202-2064
Phone (601) 292-4261

151 E Metro Dr
Flowood, MS 39232-4405

151 E Metro Pkwy
Suite 201
Flowood, MS 39232-4405
Phone (601) 973-1680

401 Baptist Dr
Suite 104
Madison, MS 39110-2010
Phone (601) 973-1504

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.38 of 100Reported as group
Quality
54.22
Promoting interoperability
100
Improvement activities
40
Cost
73.72

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Foundation of Central Ms CurrentSince May 31, 2022 Accepting new patients
Medical Foundation of Central Mississippi, Inc. Otolaryngology CurrentSince May 31, 2022 Accepting new patients
The Oregon Clinic PC Past Accepting new patients

Locations

151 E Metro Dr
Ste 102
Flowood, MS 39232
Phone (601) 973-1680

1225 N State St
Jackson, MS 39202
Phone (601) 292-4261

401 Baptist Dr
Ste 104
Madison, MS 39110
Phone (601) 605-2383

Organizations & group practices 3

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 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": "1364947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654214400000",
    "number": "1558604934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "249 EASTBROOKE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164716",
            "telephone_number": "601-672-4263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 E METRO DR STE 102",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392324404",
            "telephone_number": "601-973-1680",
            "fax_number": "601-973-1681"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2222 NW Lovejoy St Ste 622",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "97210",
            "country_code": "US",
            "telephone_number": "503-229-8455",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "501 N Graham St Ste 500",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972272003",
            "country_code": "US",
            "telephone_number": "503-229-8455",
            "fax_number": "503-229-7028",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 N Columbia River Hwy",
            "address_purpose": "LOCATION",
            "city": "Saint Helens",
            "state": "OR",
            "postal_code": "970511299",
            "country_code": "US",
            "telephone_number": "503-229-8455",
            "fax_number": "503-229-7028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHIMMEL",
        "first_name": "ELIZABETH",
        "middle_name": "KATHERINE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-03",
        "last_updated": "2022-06-03",
        "certification_date": "2022-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "OR",
            "license": "MD188118",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MS",
            "license": "30023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500659886",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flowood, MS

Sources for this page

Verify at the official NPI Registry.