Individual provider Active NPI

Benjamin Perry Folk III, M.D.

  • Specialist
  • Greenville, MS
National Provider Identifier
1629010012
Registry record updated Jan 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
10931 Issued in MS
Practice address
1502 S Colorado St
Greenville, MS 38703-7219
Phone
(662) 332-9872
Fax
(662) 378-0290
NPI assigned
Jun 12, 2006
Last updated
Jan 3, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 10931 MS Primary

Addresses

Primary practice location

1502 S Colorado St
Greenville, MS 38703-7219

Mailing address

1502 S Colorado St
Greenville, MS 38703-7219
Phone (662) 332-9872

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, MS2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20080912000396 AR Practitioner - Cardiovascular Disease (Cardiology) 4880629492 Practice locations: Lake Village, AR
I20100211000297 MS Practitioner - Cardiovascular Disease (Cardiology) 4880629492 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Vanderbilt University School of Medicine, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Greenville ClinicGroup PAC ID 4082694641, 8 clinicians

Practice addresses (Care Compare)

1502 S Colorado St
Greenville, MS 38703-7219
Phone (662) 332-9872

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10931MSMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
The Greenville Clinic CurrentSince Jun 23, 1986 Accepting new patients

Locations

1502 S Colorado St
Greenville, MS 38703
Phone (601) 332-9872

Interoperability endpoints

  • Direct secure messaging: benjaminfolkiii@tgcpa.allscriptsdirect.net

Organizations & group practices 1

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 9

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": "1578009600000",
    "number": "1629010012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1502 S COLORADO ST",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "387037219",
            "telephone_number": "662-332-9872",
            "fax_number": "662-378-0290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 S COLORADO ST",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "387037219",
            "telephone_number": "662-332-9872",
            "fax_number": "662-378-0290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOLK",
        "first_name": "BENJAMIN",
        "middle_name": "PERRY",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2020-01-03",
        "certification_date": "2020-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MS",
            "license": "10931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, MS

Sources for this page

Verify at the official NPI Registry.