Individual provider Active NPI

William Edward Seely III, M.D.

  • Interventional Pain Medicine Physician
  • Jackson, TN
National Provider Identifier
1609163880
Registry record updated Mar 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
54063 Issued in TN
Practice address
219 Stonebridge Blvd
Jackson, TN 38305-2040
Phone
(731) 661-9825
NPI assigned
Jul 7, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 23847 MS
Interventional Pain Medicine Physician 208VP0014X 54063 TN Primary

Addresses

Primary practice location

219 Stonebridge Blvd
Jackson, TN 38305-2040

Mailing address

24 Physicians Dr
Jackson, TN 38305-2085
Phone (731) 661-9825

Other practice location 1

2500 N State St
Jackson, MS 39216-4500
Phone (601) 815-1196

Other identifiers 1

IdentifierTypeStateIssuer
09956264MedicaidMS

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
I20240516001133 MS Practitioner - Interventional Pain ManagementPractitioner - Anesthesiology 0042536914 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional Pain ManagementAlso: Anesthesiology
Education
University of Mississippi School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Specialty Orthopedic Group of Mississippi PLLCGroup PAC ID 3577878883, 41 clinicians

Practice addresses (Care Compare)

1211 S Gloster St
Suite a
Tupelo, MS 38801-6548
Phone (662) 767-4200

Hospital & facility affiliations

  • North Mississippi Medical Center Hospital, Tupelo, MS, CCN 250004
  • Magnolia Regional Health Center Hospital, Corinth, MS, CCN 250009
  • North Mississippi Medical Center-Gilmore Amory Hospital, Amory, MS, CCN 250025

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Merit-based Incentive Payment System (MIPS)

Final score
91.05 of 100Reported as group
Promoting interoperability
98
Improvement activities
40
Cost
73.85

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Mississippi Medical Center Current Accepting new patients
Specialty Orthopedic Group of Mississippi PLLC Current Accepting new patients
Medical Center Anesthesia Inc. Anesthesiology CurrentSince Aug 1, 2016 Accepting new patients
Specialty Orthopedic Group of Mississippi PLLC CurrentSince Jul 1, 2024 Accepting new patients
Specialty Orthopedic Group of Ms, PLLC CurrentSince Jul 1, 2024 Accepting new patients
Jackson Anesthesiology Group, PLLC Anesthesiology PastSince Dec 6, 2020 Accepting new patients

Locations

100 Baptist Memorial Cir
Ste 330
Oxford, MS 38655
Phone 6627674200 ext. 1057

1211 S Gloster St
Ste A
Tupelo, MS 38801
Phone (662) 377-3380

620 Skyline Dr
Jackson, TN 38301
Phone (731) 541-4923

Interoperability endpoints

  • Direct secure messaging: williamseely@nmhs.medalliesdirect.net

Organizations & group practices 6

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 3

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": "1309996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678838400000",
    "number": "1609163880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 PHYSICIANS DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052085",
            "telephone_number": "731-661-9825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 STONEBRIDGE BLVD",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052040",
            "telephone_number": "731-661-9825"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 N State St",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "392164500",
            "country_code": "US",
            "telephone_number": "601-815-1196",
            "fax_number": "601-984-5939",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEELY",
        "first_name": "WILLIAM",
        "middle_name": "EDWARD",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-07",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MS",
            "license": "23847",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "TN",
            "license": "54063",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09956264",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.