NPIMap

Individual provider Active NPI

Stephen C Hammack, MD

  • Family Medicine Physician
  • Flowood, MS
National Provider Identifier
1639396393
Registry record updated Jun 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
19226 Issued in MS
Practice address
294 E Layfair Dr
Flowood, MS 39232-9526
Phone
(601) 414-6520
NPI assigned
Apr 20, 2007
Last updated
Jun 12, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 19226 MS Primary

Addresses

Primary practice location

294 E Layfair Dr
Flowood, MS 39232-9526

Mailing address

PO Box 23996
Jackson, MS 39225
Phone (601) 206-6100

Other practice location 1

286 Calhoun Station Pkwy
Madison, MS 39110-5537
Phone (601) 200-4321

Other practice location 2

332 Highway 12 West
Kosciusko, MS 39090
Phone (662) 289-1800

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
I20070908000084 MS Practitioner - Family Practice 5698868560 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Mississippi School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hattiesburg Clinic PAGroup PAC ID 5193706794, 525 clinicians

Practice addresses (Care Compare)

415 S 28TH Ave
Hattiesburg, MS 39401-7246
Phone (601) 264-6000

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
St Dominic Medical Associates LLC CurrentSince Mar 1, 2020 Accepting new patients
Hattiesburg Clinic PA CurrentSince May 22, 2023 Accepting new patients
Hattiesburg Clinic, PA CurrentSince May 22, 2023 Accepting new patients
Hattiesburg Clinic, PA Past Accepting new patients
St. Dominic Medical Associates LLC Family Medicine Past Accepting new patients
St Dominic Medical Associates LLC Past Accepting new patients
Premier Medical Group of Mississippi LLC Past Accepting new patients
St. Dominic Medical Associates LLC Family Medicine Past Accepting new patients

Locations

294 E Layfair Dr
Flowood, MS 39232
Phone (601) 414-6520

415 S 28th Ave
Hattiesburg, MS 39401
Phone (601) 261-3606

106 Highland Way
Ste 202
Madison, MS 39110
Phone (601) 200-3376

Interoperability endpoints

  • Direct secure messaging: shammack130409@directpatientrecord.com

Organizations & group practices 9

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 3

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": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1639396393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23996",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39225",
            "telephone_number": "601-206-6100",
            "fax_number": "601-206-6052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "294 E LAYFAIR DR",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329526",
            "telephone_number": "601-414-6520"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "286 Calhoun Station Pkwy",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "MS",
            "postal_code": "391105537",
            "country_code": "US",
            "telephone_number": "601-200-4321",
            "fax_number": "601-859-0159",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "332 Highway 12 West",
            "address_purpose": "LOCATION",
            "city": "Kosciusko",
            "state": "MS",
            "postal_code": "39090",
            "country_code": "US",
            "telephone_number": "662-289-1800",
            "fax_number": "662-289-2486",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAMMACK",
        "first_name": "STEPHEN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-20",
        "last_updated": "2023-06-12",
        "certification_date": "2021-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "19226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flowood, MS

Sources for this page

Verify at the official NPI Registry.