James D. Edmonson, M.D.
Individual provider Active NPI Surgery Physician · Corinth, MS
NPI 1689617664 · NPPES record last updated Aug 25, 2020
Key facts
- NPI
- 1689617664
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgery Physician 208600000X
- License
- 13579 (MS)
- Practice address
- 2429 Proper St
Corinth, MS 38834-5394 - Phone
- (662) 286-3735
- Fax
- (662) 286-3721
- NPI assigned
- Jun 14, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 5
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- General Surgery
- Education
- University of Tennessee, HSC, College of Medicine, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
2429 Proper St
Corinth, MS 38834-5394
Phone (662) 286-3735
Hospital & facility affiliations
- Baptist Memorial Hospital Booneville
- Tippah County Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 68 |
| Hernia repair - groin (open) | 1-10 |
| Pacemaker insertion or repair | 1-10 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 137 |
| Melanoma (skin cancer) excision | 1-10 |
| Removal of tissue | 16 |
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 |
|---|---|---|---|---|
| I20120328000792 | MS | Practitioner - General Surgery | 6103875497 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13579 | MS | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tippah County Hospital | Current |
Accepting new patients | |
| Corinth Surgical Clinic, P.a. | Specialist | Current |
Accepting new patients |
| Corinth Pulmonary Clinic and Rehabilitation, PA | Single Specialty | Current | Accepting new patients |
| Tippah County Hospital | Current |
Accepting new patients | |
| Tippah County Hospital | Past | Accepting new patients |
Locations
2429 Proper St
Corinth, MS 38834
Phone (662) 284-9502
703 Alcorn Dr
Ste 111
Corinth, MS 38834
Phone (662) 286-1901
1005 City Ave N
Ripley, MS 38663
Phone (601) 837-9221
705 E Poplar Ave
Ste 2000
Selmer, TN 38375
Phone (731) 646-2181
Interoperability endpoints
- https://fhir-usa.unify.chbase.com/org/tippah-ba3c06de
- corinthsurgicalclinic.jamesedmonson@147032.advancedmd-direct.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician |
208600000X | 13579 | MS | Yes |
Addresses
Primary practice location
2429 Proper St
Corinth, MS 38834-5394
Mailing address
2429 Proper St
Corinth, MS 38834-5394
Phone (662) 286-3735
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 26282 | Other | TN | VESTICA |
| 12658 | Other | TN | TLC |
| 157866 | Other | TN | UNISON |
| 3104220 | Other | TN | BCBS |
| 3729733 | Medicaid | TN | |
| 0114762 | Medicaid | MS |
Other providers in Corinth, MS
- Easy Care Medical Clinic,PLLC
- Mary Eaton
- Stephanie Leigh Eaton
- Tara Edmond
- Rhiannon Edmondson
- Chris Elliott
- David Matthew Ellis
- Larry D. Ellis
- Besseri Emmanuel Christian Ako
- Empowering Wellness
All providers in Corinth, MS · Surgery 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 Aug 25, 2020. 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.