NPIMap

Individual provider Active NPI

William Kirk Haney, M.D.

  • Diagnostic Radiology Physician
  • Tupelo, MS
National Provider Identifier
1609818442
Registry record updated Mar 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
13244 Issued in MS
Practice address
620 Crossover Road
Tupelo, MS 38801-4944
Phone
(662) 620-7102
Fax
(662) 620-7106
NPI assigned
Jun 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 13244 MS Primary

Addresses

Primary practice location

620 Crossover Road
Tupelo, MS 38801-4944

Mailing address

Post Office Box 980
Tupelo, MS 38802-0980
Phone (662) 620-7102

Other identifiers 5

IdentifierTypeStateIssuer
P01399779OtherMSRAILROAD MEDICAR
191189MedicaidAL
300117809OtherMSRAILROAD MEDICARE
009949340MedicaidAL
00116563MedicaidMS

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
I20041208001090 MS Practitioner - Diagnostic Radiology 9335100692 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Tennessee, HSC, College of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

107 Eureka St B
Ummc Medical Clinic Batesville
Batesville, MS 38606-2533
Phone (601) 815-2005

2500 N State St
Jackson, MS 39216-4500
Phone (601) 984-6441

960 Avent Dr
Grenada, MS 38901-5230
Phone (662) 227-7000

965 Avent Dr
Grenada, MS 38901-5045
Phone (662) 227-7444

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.94 of 100Reported as group
Quality
67.75
Promoting interoperability
100
Improvement activities
40
Cost
71.17

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
State of Mississippi-University of Mississippi Medical Center CurrentSince Nov 5, 2014 Accepting new patients
State of Mississippi - University of Mississippi Medical Center Current Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Nov 5, 2014 Accepting new patients
Claiborne County Hospital Diagnostic Radiology CurrentSince Feb 1, 2026 Accepting new patients
Amory Primary Medicine Clinic Past Accepting new patients

Locations

1105 Earl Frye Blvd
Amory, MS 38821
Phone (662) 256-7111

965 Avent Dr
Ste 100A
Grenada, MS 38901
Phone (662) 227-7000

2500 N State St
Jackson, MS 39216
Phone (601) 815-4775

239 Bowling Green Rd
Lexington, MS 39095
Phone (662) 834-1321

123 McComb Ave
Port Gibson, MS 39150
Phone (601) 437-5141

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 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": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490659200000",
    "number": "1609818442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "POST OFFICE BOX 980",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388020980",
            "telephone_number": "662-620-7102",
            "fax_number": "662-620-7106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 CROSSOVER ROAD",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014944",
            "telephone_number": "662-620-7102",
            "fax_number": "662-620-7106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANEY",
        "first_name": "WILLIAM",
        "middle_name": "KIRK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2017-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MS",
            "license": "13244",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICAR",
            "identifier": "P01399779",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "191189",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "300117809",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009949340",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00116563",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tupelo, MS

Sources for this page

Verify at the official NPI Registry.