Brookhaven Internal Medicine, P.a.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

BROOKHAVEN INTERNAL MEDICINE, P.A.

Practice address

527 Silver Cross Dr
Brookhaven, MS 39601-2388

Phone

(601) 835-0507

Fax

(601) 835-2766

NPI assigned

Aug 30, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Diane M Price

Title

Office Manager

Phone

(601) 835-0507

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Interoperability endpoints

• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.73319

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Bryan S Calcote, M.D.

  • Internal Medicine Physician
  • Brookhaven, MS
  • NPI 1073622999
  Medicare reassignment NPD
• Tonya C Hughey, CFNP

  • Family Nurse Practitioner
  • Brookhaven, MS
  • NPI 1013026947
  NPD
• Dena W Jackson, M.D.

  • Internal Medicine Physician
  • Brookhaven, MS
  • NPI 1477663318
  NPD (past)

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1699884528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3730",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "396037730",
            "telephone_number": "601-835-0507",
            "fax_number": "601-835-2766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "527 SILVER CROSS DR",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "396012388",
            "telephone_number": "601-835-0507",
            "fax_number": "601-835-2766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKHAVEN INTERNAL MEDICINE, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PRICE",
        "authorized_official_first_name": "DIANE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "601-835-0507"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brookhaven Anesthesia & Pain Management
• Brookhaven Children's Clinic
• Brookhaven Crisis Center (MSH Brookhaven Crisis Center)
• Brookhaven Diabetes and Primary Care Clinic
• Brookhaven Ear, Nose & Throat PA
• Brookhaven Ms Opco LLC
• Brookhaven Ms Operating LLC (Lincoln Residential Center)
• Brookhaven OB-GYN Associates, PA
• Brookhaven Optical Inc (Optical Outlet)
• Brookhaven Psychological Associates

• Internal Medicine Physician in Brookhaven, MS
• Providers in Brookhaven, 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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.