Individual provider Active NPI

Muneeba Qayyum, MD

  • Internal Medicine Physician
  • Southaven, MS
National Provider Identifier
1609228568
Registry record updated Apr 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
27035 Issued in MS
Practice address
7601 Southcrest Pkwy
Southaven, MS 38671-4739
Phone
(662) 772-2980
Fax
(662) 772-2960
NPI assigned
Jul 4, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X E-14132 AR
Internal Medicine Physician 207R00000X 59629 TN
Internal Medicine Physician 207R00000X 27035 MS Primary

Addresses

Primary practice location

7601 Southcrest Pkwy
Southaven, MS 38671-4739

Mailing address

965 Ridge Lake Blvd Ste 103
Memphis, TN 38120-9446

Other practice location 1

6019 Walnut Grove Rd
Memphis, TN 38120-2113
Phone (901) 226-3610

Other practice location 2

2100 N 7th St
West Memphis, AR 72301-2017
Phone (901) 226-3610

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MS, AR3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20191011002105 TN Practitioner - Internal Medicine 7416288089 Reassigns benefits to 2 organizations
I20191015000192 MS Practitioner - Internal Medicine 7416288089 Reassigns benefits to 1 organization
I20210414001695 AR Practitioner - Internal Medicine 7416288089 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Intensivist Services PCGroup PAC ID 9335152107, 234 clinicians
Southeastern Physician Services PCGroup PAC ID 0042307852, 591 clinicians
Greenbrook Physician Services, LLCGroup PAC ID 5597267427, 70 clinicians

Practice addresses (Care Compare)

2100 N 7TH St
West Memphis, AR 72301-2017
Phone (870) 394-7800

6019 Walnut Grove Rd
Memphis, TN 38120-2113
Phone (901) 226-5000

7601 Southcrest Pkwy
Southaven, MS 38671-4739
Phone (662) 772-4000

Hospital & facility affiliations

  • Baptist Memorial Hospital-Crittenden, Inc Hospital, West Memphis, AR, CCN 040156
  • Baptist Memorial Hospital Hospital, Memphis, TN, CCN 440048
  • Baptist Memorial Hospital Desoto Hospital, Southaven, MS, CCN 250141
  • Baptist Memorial Hospital Tipton Hospital, Covington, TN, CCN 440131

Merit-based Incentive Payment System (MIPS)

Final score
81.87 of 100Reported as group
Quality
64.75
Promoting interoperability
100
Improvement activities
40
Cost
74.81

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
27035MSMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Intensivist Services PC Internal Medicine CurrentSince Oct 1, 2025 Accepting new patients
Southeastern Physician Services PC Internal Medicine CurrentSince Sep 15, 2025 Accepting new patients
Greenbrook Physician Services, LLC Internal Medicine CurrentSince Oct 1, 2025 Accepting new patients

Locations

2100 N 7th St
West Memphis, AR 72301
Phone (870) 394-7800

7601 Southcrest Pkwy
Southaven, MS 38671
Phone (662) 349-4000

6019 Walnut Grove Rd
Memphis, TN 38120
Phone (901) 226-3190

1201 Bishop St
Union City, TN 38261
Phone (423) 698-6061

Interoperability endpoints

  • Direct secure messaging: mqayyum309863@direct.bmhcc.org

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 4

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": "1467590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617840000000",
    "number": "1609228568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 RIDGE LAKE BLVD STE 103",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381209446",
            "fax_number": "901-227-8591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7601 SOUTHCREST PKWY",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386714739",
            "telephone_number": "662-772-2980",
            "fax_number": "662-772-2960"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6019 Walnut Grove Rd",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381202113",
            "country_code": "US",
            "telephone_number": "901-226-3610",
            "fax_number": "901-226-3612",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2100 N 7th St",
            "address_purpose": "LOCATION",
            "city": "West Memphis",
            "state": "AR",
            "postal_code": "723012017",
            "country_code": "US",
            "telephone_number": "901-226-3610",
            "fax_number": "901-226-3612",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QAYYUM",
        "first_name": "MUNEEBA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-04",
        "last_updated": "2021-04-08",
        "certification_date": "2021-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "E-14132",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "59629",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "27035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southaven, MS

Sources for this page

Verify at the official NPI Registry.