Kenneth W Stubbs, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

09681 Issued in MS

Practice address

46 Sergeant Prentiss Dr.
Suite 300
Natchez, MS 39120

Phone

(601) 446-2084

Fax

(601) 442-3024

NPI assigned

Jun 10, 2006

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 1, 2015 through Jan 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Natchez After Hours Clinic, P.L.L.C.

  • General Practice Physician
  • Natchez, MS
  • NPI 1982634051
  NPD (past)
• Natchez Anesthesia

  • Anesthesiology Physician
  • Natchez, MS
  • NPI 1831203165
  NPD (past)
• Natchez Community Hospital LLC

  dba Natchez Community Hospital

  • General Acute Care Hospital
  • Natchez, MS
  • NPI 1619922283
  NPD (past)
• Natchez Hma Physician Management LLC

  • Family Medicine Physician
  • Natchez, MS
  • NPI 1386684199
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1659312585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 SEARGENT PRENTISS DR.",
            "address_2": "SUITE 300",
            "city": "NATCHEZ",
            "state": "MS",
            "postal_code": "39120",
            "telephone_number": "601-446-2084",
            "fax_number": "601-442-3024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 SERGEANT PRENTISS DR.",
            "address_2": "SUITE 300",
            "city": "NATCHEZ",
            "state": "MS",
            "postal_code": "39120",
            "telephone_number": "601-446-2084",
            "fax_number": "601-442-3024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUBBS",
        "first_name": "KENNETH",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-10",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "15220",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "09681",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00012515",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy C Stevens, OTRL
• Christina W Stewart
• Natasha Antoinette Stewart
• Evelyn Ann Stiner, PHD FNP
• Tommie Brian Stretch, M.D.
• April Swilley, M.S., CCC-SLP
• Joe Swoveland, LPC
• Tarsha C Ambeau
• Tarsha C Ambeau Dba US Star Nursing
• Taylor and Ball Orthopedic Clinic PA (Taylor Orthopedic Clinic Eugene E Taylor MD)

• Internal Medicine Physician in Natchez, MS
• Providers in Natchez, MS by specialty
• Internal Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.