Individual provider Active NPI

Matthew Kenyon George, M.D.

  • Internal Medicine Physician
  • Jackson, MS
National Provider Identifier
1659383297
Registry record updated Nov 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
22585 Issued in MS
Practice address
1225 N State St
Jackson, MS 39202-2064
Phone
(601) 988-5281
Fax
(601) 974-6241
NPI assigned
Aug 12, 2006
Last updated
Nov 17, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X 22585 MS
Internal Medicine Physician 207R00000X 22585 MS Primary

Addresses

Primary practice location

1225 N State St
Jackson, MS 39202-2064

Mailing address

965 Ridge Lake Blvd Ste 103
Memphis, TN 38120-9446

Other identifiers 1

IdentifierTypeStateIssuer
04478370MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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 1

Enrollment IDStateProvider typePAC IDDetails
I20130820000671 MS Practitioner - Internal Medicine 4284531096 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Louisiana State University School of Medicine in New Orleans, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1225 N State St
Jackson, MS 39202-2064
Phone (601) 292-4261

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.38 of 100Reported as group
Quality
54.22
Promoting interoperability
100
Improvement activities
40
Cost
73.72

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22585MSMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mississippi Baptist Medical Center, Inc. CurrentSince Dec 1, 2015 Accepting new patients
Mississippi Baptist Medical Center, Inc. Current Accepting new patients
Baptist Jackson Heart Cardiology Clinic-Yazoo City CurrentSince Sep 1, 2018 Accepting new patients
Mississippi Baptist Medical Center, Inc CurrentSince Dec 1, 2015 Accepting new patients
Medical Foundation of Central Mississippi, Inc. Internal Medicine Current Accepting new patients
Mississippi Baptist Medical Center, Inc. Past Accepting new patients

Locations

1225 N State St
Jackson, MS 39202
Phone (601) 292-4261

401 Baptist Dr
Ste 104
Madison, MS 39110
Phone (601) 605-2383

965 Ridge Lake Blvd
Ste 103
Memphis, TN 38120
Phone (901) 227-3221

Interoperability endpoints

  • Direct secure messaging: mgeorge148958@direct.bmhcc.org

Organizations & group practices 6

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 1

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": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668643200000",
    "number": "1659383297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 RIDGE LAKE BLVD STE 103",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381209446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022064",
            "telephone_number": "601-988-5281",
            "fax_number": "601-974-6241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGE",
        "first_name": "MATTHEW",
        "middle_name": "KENYON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "MS",
            "license": "22585",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "22585",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04478370",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.