Imad Tahboub, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

23349 Issued in MS

Practice address

215 Marion Ave
McComb, MS 39648-2705

Phone

(601) 249-5500

Fax

(601) 249-1173

NPI assigned

Sep 27, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AL, MS, FL3 enrollments

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 3

Specialty

Internal MedicineAlso: Nephrology

Education

Other, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oak Mountain Group Services, LLCGroup PAC ID 3678886256, 62 clinicians

North Mississippi Medical Center, Inc.Group PAC ID 9931010600, 361 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• North Mississippi Medical Center Hospital, Tupelo, MS, CCN 250004
• Grandview Medical Center Hospital, Birmingham, AL, CCN 010104

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/22582/brand/1/csg/1/fhir/r4
• FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4
• Direct secure messaging: imadtahboub@nmhs.medalliesdirect.net

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.

• North Mississippi Medical Center Inc

  • Psychologist
  • Tupelo, MS
  • NPI 1972608347
  Medicare reassignment Care Compare group NPD
• Oak Mountain Group Services, LLC

  • Hospitalist Physician
  • Birmingham, AL
  • NPI 1366840761
  Medicare reassignment Care Compare group NPD
• Houston County Healthcare Authority

  • Internal Medicine Physician
  • Enterprise, AL
  • NPI 1619026606
  Medicare reassignment NPD
• Marion Regional Medical Center, Inc.

  • General Acute Care Hospital
  • Hamilton, AL
  • NPI 1932160082
  Medicare reassignment NPD
• Pensacola Hospitalist Physicians, LLC

  • Hospitalist Physician
  • Pensacola, FL
  • NPI 1487254140
  Medicare reassignment NPD
• Pinnacle Physician Group, LLP

  • Hospitalist Physician
  • Tuscaloosa, AL
  • NPI 1609008176

  Internal Medicine

  Medicare reassignment NPD
• The DCH Healthcare Authority

  • General Acute Care Hospital
  • Tuscaloosa, AL
  • NPI 1841394418
  Medicare reassignment NPD
• Internal Medicine Associates, PC

  • Internal Medicine Physician
  • Flint, MI
  • NPI 1649319526
  NPD (past) Authorized official
• North Mississippi Medcial Center, Inc.

  • Family Nurse Practitioner
  • Tupelo, MS
  • NPI 1467948687
  NPD
• North Mississippi Medcial Center, Inc.

  • Diagnostic Radiology Physician
  • Tupelo, MS
  • NPI 1902762487
  NPD
• North Mississippi Medical Center

  • General Acute Care Hospital
  • Tupelo, MS
  • NPI 1376969683
  NPD
• DCH Healthcare Authority

  • Hematology & Oncology Physician
  • Tuscaloosa, AL
  • NPI 1699019539

  Internal Medicine

  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• North Mississippi Medical Center, Inc.

  • General Acute Care Hospital
  • Tupelo, MS
  • NPI 1598875460
  Care Compare affiliation
• Affinity Hospital LLC

  • General Acute Care Hospital
  • Birmingham, AL
  • NPI 1023061405
  Care Compare affiliation

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

{
    "created_epoch": "1127779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619654400000",
    "number": "1669468336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 490",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396490490",
            "telephone_number": "601-250-4366",
            "fax_number": "601-250-4367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 MARION AVE",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396482705",
            "telephone_number": "601-249-5500",
            "fax_number": "601-249-1173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAHBOUB",
        "first_name": "IMAD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-27",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "IT053374",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "31196",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "23349",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03404537",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "131779",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sandy Summers
• Timothy Summers, MD
• Candice Sumrall, FNP
• Dawn M Sumrall, M.D.
• SW Ms Mental Health Mental Retardation Commission
• Patrick Evan Tarpy, M.D., F.A.A.P.
• Aundrea Chablis Tate
• Sunja Tate, NP-C
• Betty H Taylor, RN
• Darryl Temple, FNP

• Internal Medicine Physician in McComb, MS
• Providers in McComb, 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 Apr 29, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.