Stephen C Hammack, MD
Individual provider Active NPI Family Medicine Physician · Flowood, MS
NPI 1639396393 · NPPES record last updated Jun 12, 2023
Key facts
- NPI
- 1639396393
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 19226 (MS)
- Practice address
- 294 E Layfair Dr
Flowood, MS 39232-9526 - Phone
- (601) 414-6520
- NPI assigned
- Apr 20, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 9
Hospital & facility affiliations 3
Medicare Care Compare profile
- 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 PA
Practice addresses (Care Compare)
415 S 28TH Ave
Hattiesburg, MS 39401-7246
Phone (601) 264-6000
Hospital & facility affiliations
- Sta Home Health Agency of Jackson, Inc. Dba Accentcare Home Health of Jackson
- St Dominic-Jackson Memorial Hospital
- Mississippi Baptist Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in 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 |
|---|---|---|---|---|
| I20070908000084 | MS | Practitioner - Family Practice | 5698868560 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hattiesburg Clinic PA | Current |
Accepting new patients | |
| St Dominic Medical Associates LLC | Current |
Accepting new patients | |
| Hattiesburg Clinic, PA | Current |
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 | 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 |
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
- shammack130409@directpatientrecord.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 19226 | MS | Yes |
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
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 07838781 | Medicaid | MS |
Other providers in Flowood, MS
- Jamie Guyton
- Karla Haik
- Callie Brown Hall
- Charles E Hall
- Wendy Hamilton
- Grace Fairley Hampton
- Sheryl Hampton
- Alisia Chevese Hankins
- Christina Hansen
- Christopher Stephen Hanson
All providers in Flowood, MS · Family Medicine Physician in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 12, 2023. 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.