NPIMap

Individual provider Active NPI

Deanna Nabors, MD

  • Internal Medicine Physician
  • Southaven, MS
National Provider Identifier
1619939204
Registry record updated Mar 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
18687 Issued in MS
Practice address
3451 Goodman Rd E Ste 115
Southaven, MS 38672-9304
Phone
(662) 890-5555
Fax
(662) 890-8899
NPI assigned
Apr 6, 2006
Last updated
Mar 29, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 18687 MS Primary

Addresses

Primary practice location

3451 Goodman Rd E Ste 115
Southaven, MS 38672-9304

Mailing address

3451 Goodman Rd E
Ste 115
Southaven, MS 38672-9304
Phone (662) 890-5555

Other identifiers 1

IdentifierTypeStateIssuer
03037321MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, TN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20041123000416 MS Practitioner - Internal MedicinePractitioner - Pediatric Medicine 2264423664 Reassigns benefits to 2 organizations
I20210831000500 TN Practitioner - Internal Medicine 2264423664 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
University of Tennessee, HSC, College of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Family Medical Clinic of North Ms IncGroup PAC ID 5294790861, 13 clinicians

Practice addresses (Care Compare)

3451 Goodman Rd E
Suite 115
Southaven, MS 38672-9304
Phone (662) 890-5555

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Segue Health Partners LLC CurrentSince Aug 1, 2021 Accepting new patients
Segue Health of Mississippi LLC CurrentSince Mar 12, 2021 Accepting new patients
Christ Community Health Services Inc CurrentSince Jun 1, 2023 Accepting new patients
Christ Community Health Services Inc CurrentSince Jun 1, 2023 Accepting new patients
Brian K. Nadolne, MD, PC Past Accepting new patients
Ut Medical Group, Inc. Past Accepting new patients
Ut Medical Group Inc Internal Medicine PastSince Nov 1, 1998 Accepting new patients

Locations

232 Market St
Jackson, MS 39232
Phone (588) 498-6767

2595 Central Ave
Memphis, TN 38104
Phone (901) 260-8500

3362 S 3rd St
Memphis, TN 38109
Phone (901) 271-6300

969 Frayser Blvd
Memphis, TN 38127
Phone (901) 260-8400

Organizations & group practices 8

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": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553817600000",
    "number": "1619939204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3451 GOODMAN RD E",
            "address_2": "STE 115",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386729304",
            "telephone_number": "662-890-5555",
            "fax_number": "662-420-7525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3451 GOODMAN RD E STE 115",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386729304",
            "telephone_number": "662-890-5555",
            "fax_number": "662-890-8899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NABORS",
        "first_name": "DEANNA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-06",
        "last_updated": "2019-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "18687",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03037321",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southaven, MS

Sources for this page

Verify at the official NPI Registry.