Individual provider Active NPI

Stephen A Coachys, M.D.

  • Family Medicine Physician
  • Jackson, MS
National Provider Identifier
1669420915
Registry record updated Sep 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
17784 Issued in MS
Practice address
5606 Old Canton Rd
Jackson, MS 39211-4217
Phone
(601) 957-3333
Fax
(601) 957-3335
NPI assigned
May 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2015

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 17784 MS Primary

Addresses

Primary practice location

5606 Old Canton Rd
Jackson, MS 39211-4217

Mailing address

308 Corporate Dr
Ridgeland, MS 39157-8803
Phone (601) 898-7500

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
I20040824000565 MS Practitioner - Family Practice 7517931652 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Mississippi School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Quad Intermed Company LLCGroup PAC ID 6709245954, 42 clinicians

Practice addresses (Care Compare)

307 E Fifteenth St
MMS Medical Clinic Yazoo City
Yazoo City, MS 39194-2631
Phone (662) 746-8530

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17784MSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Quad Intermed Company LLC CurrentSince Aug 1, 2023 Accepting new patients
Quad Intermed Company LLC Current Accepting new patients
Careplus Lakeview Family Medicine Family Medicine CurrentSince Oct 1, 2008 Accepting new patients
Quad Intermed Company LLC CurrentSince Aug 1, 2023 Accepting new patients
Reservoir Family Medical Clinic, PA Family Medicine Current Accepting new patients
River Oaks Management Company LLC Family Medicine CurrentSince Oct 1, 2008 Accepting new patients
Batesville Emergency Physicians Past Accepting new patients

Locations

1030 River Oaks Dr
Jackson, MS 39232
Phone (601) 376-2165

7215 S Siwell Rd
Jackson, MS 39272
Phone (601) 373-2204

342 Gilchrist Dr
Pearl, MS 39208
Phone (601) 939-0700

308 Corporate Dr
Ridgeland, MS 39157
Phone (601) 898-7500

4204 Clay St
#V
Vicksburg, MS 39183
Phone (601) 619-7717

4204 Clay St
Vicksburg, MS 39183
Phone (601) 200-4560

307 E Fifteenth St
Yazoo City, MS 39194
Phone (662) 746-2113

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/7115/brand/1/csg/1/fhir/r4

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442275200000",
    "number": "1669420915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 CORPORATE DR",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391578803",
            "telephone_number": "601-898-7500",
            "fax_number": "601-898-7577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5606 OLD CANTON RD",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392114217",
            "telephone_number": "601-957-3333",
            "fax_number": "601-957-3335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COACHYS",
        "first_name": "STEPHEN",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2015-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "17784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.