Benjamin Perry Folk III, M.D.
Individual provider Active NPI Specialist · Greenville, MS
NPI 1629010012 · NPPES record last updated Jan 3, 2020
Key facts
- NPI
- 1629010012
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- 10931 (MS)
- Practice address
- 1502 S Colorado St
Greenville, MS 38703-7219 - Phone
- (662) 332-9872
- Fax
- (662) 378-0290
- NPI assigned
- Jun 12, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Hospital & facility affiliations 9
Medicare Care Compare profile
- 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 Clinic
Practice addresses (Care Compare)
1502 S Colorado St
Greenville, MS 38703-7219
Phone (662) 332-9872
Hospital & facility affiliations
- Delta Health System - the Medical Center
- Chicot Memorial Medical Center
- Sharkey Issaquena Community Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in AR, MS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080912000396 | AR | Practitioner - Cardiovascular Disease (Cardiology) | 4880629492 | Practice locations: Lake Village, AR |
| I20100211000297 | MS | Practitioner - Cardiovascular Disease (Cardiology) | 4880629492 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Greenville Clinic | Current |
Accepting new patients |
Locations
1502 S Colorado St
Greenville, MS 38703
Phone (601) 332-9872
Interoperability endpoints
- benjaminfolkiii@tgcpa.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 10931 | MS | Yes |
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
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 060024546 | Other | MS | RR MEDICARE |
| 4376234 | Other | MS | AETNA PIN |
| 0016500 | Medicaid | MS | |
| 112656001 | Other | MS | AR MEDICAID |
Other providers in Greenville, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 3, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.