Marshall Gray Edmondson, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

06183 Issued in MS

Practice address

620 Crossover Road
Tupelo, MS 38801-4944

Phone

(662) 620-7102

Fax

(662) 620-7106

NPI assigned

Jun 4, 2006

Last updated

Sep 26, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

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

Specialty

Diagnostic Radiology

Education

University of Mississippi School of Medicine, 1971

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oxford Pre Op and Imaging Center LLCGroup PAC ID 0840444998, 20 clinicians

Premier Radiology IncGroup PAC ID 2769452242, 26 clinicians

Baptist Memorial Hospital - Calhoun IncGroup PAC ID 5395024210, 24 clinicians

Winston County Medical FoundationGroup PAC ID 7315943255, 29 clinicians

Tate County HospitalGroup PAC ID 6103282165, 35 clinicians

Boa Vida Hospital of Aberdeen Ms LLCGroup PAC ID 0244505840, shared by 26 NPIs, 70 clinicians

Choctaw Regional Medical CenterGroup PAC ID 2567682206, 39 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Winston Medical Center Hospital, Louisville, MS, CCN 250027
• Highland Hills Medical Center Hospital, Senatobia, MS, CCN 250172
• Monroe Regional Hospital Hospital, Aberdeen, MS, CCN 251302
• BMH-Calhoun Hospital, Calhoun City, MS, CCN 251331
• Choctaw Regional Medical Center Hospital, Ackerman, MS, CCN 251334

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/19510/brand/1/csg/1/fhir/r4
• FHIR API: https://fhir-usa.unify.chbase.com/org/tippah-ba3c06de
• Direct secure messaging: marshall.edmondson.1@15070.direct.athenahealth.com

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.

• Baptist Memorial Hospital-Calhoun Inc

  • Critical Access Hospital
  • Calhoun City, MS
  • NPI 1881142461
  Medicare reassignment Care Compare group NPD
• Oxford Pre Op & Imaging Center LLC

  • Radiology Clinic/Center
  • Oxford, MS
  • NPI 1750646436
  Medicare reassignment Care Compare group NPD
• Tate County Hospital

  dba Highland Hills Medical Associates

  • Rural Health Clinic/Center
  • Senatobia, MS
  • NPI 1285331298
  Medicare reassignment Care Compare group NPD
• Winston County Medical Foundation

  dba Winston Medical Center

  • General Acute Care Hospital
  • Louisville, MS
  • NPI 1316078108
  Medicare reassignment Care Compare group NPD
• Choctaw Regional Medical Center

  dba Choctaw Medical Clinic of Ackerman

  • Family Medicine Physician
  • Ackerman, MS
  • NPI 1235547878
  Medicare reassignment Care Compare group
• Premier Radiology, Inc

  • Diagnostic Radiology Physician
  • Tupelo, MS
  • NPI 1083669121
  Medicare reassignment Care Compare group
• Boa Vida Hospital of Aberdeen, Ms, LLC

  • Critical Access Hospital
  • Aberdeen, MS
  • NPI 1285164046
  Medicare reassignment NPD
• Boa Vida Hospital of Aberdeen, Ms, LLC

  dba Monroe Regional Hospital

  • Multi-Specialty Clinic/Center
  • Aberdeen, MS
  • NPI 1710405741
  Medicare reassignment NPD
• Imaging Center at Gloster Creek Village PLLC

  • Diagnostic Radiology Physician
  • Tupelo, MS
  • NPI 1417907536
  Medicare reassignment NPD
• Imaging Centers for Excellence, LLC

  dba Premier Imaging

  • Radiology Clinic/Center
  • Starkville, MS
  • NPI 1730281148

  Diagnostic Radiology

  Medicare reassignment NPD
• Medical Imaging, LLC

  • Diagnostic Radiology Physician
  • Tupelo, MS
  • NPI 1316075864
  Medicare reassignment NPD
• Tippah County Hospital

  dba Tippah County Health Clinic

  • Primary Care Clinic/Center
  • Ripley, MS
  • NPI 1215710967
  Medicare reassignment NPD

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

• Baptist Memorial Hospital-Calhoun Inc

  • Critical Access Hospital
  • Calhoun City, MS
  • NPI 1881142461
  Care Compare affiliation
• Boa Vida Hospital of Aberdeen, Ms, LLC

  • Critical Access Hospital
  • Aberdeen, MS
  • NPI 1285164046
  Care Compare affiliation
• Choctaw Regional Medical Center

  • Critical Access Hospital
  • Ackerman, MS
  • NPI 1568879864
  Care Compare affiliation
• Tate County Hospital

  dba Highland Hills Medical Center

  • General Acute Care Hospital
  • Senatobia, MS
  • NPI 1619676251
  Care Compare affiliation
• Tate County Hospital

  dba Highland Hills Medical Associates of Strayhorn

  • Family Medicine Physician
  • Sarah, MS
  • NPI 1669349502

  Hospital

  Care Compare affiliation
• Winston County Medical Foundation

  dba Winston Medical Center

  • General Acute Care Hospital
  • Louisville, MS
  • NPI 1073597126
  Care Compare affiliation

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1720026255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "POST OFFICE BOX 980",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388020980",
            "telephone_number": "662-620-7102",
            "fax_number": "662-620-7106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 CROSSOVER ROAD",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014944",
            "telephone_number": "662-620-7102",
            "fax_number": "662-620-7106"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "140 Burke Calhoun City Rd",
            "address_purpose": "LOCATION",
            "city": "Calhoun City",
            "state": "MS",
            "postal_code": "389169690",
            "country_code": "US",
            "telephone_number": "662-628-6622",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDMONDSON",
        "first_name": "MARSHALL",
        "middle_name": "GRAY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-04",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MS",
            "license": "06183",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00014322",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "300020470",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009700310",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dax M Eckard, OD
• Elizabeth Eckard, O.D.
• Walter W Eckman, M.D.
• Ed Holliday, D.M.D., Inc.
• Lindsay Claire Edmondson, NURSE PRACTITIONER
• William R Edmonson, MD
• Michael Earnest Edwards, MD
• Sumbul Ejaz, MD
• April Teresa Elam
• Abdullah Sufian Elassouli, DDS

• Diagnostic Radiology Physician in Tupelo, MS
• Providers in Tupelo, MS by specialty
• Diagnostic Radiology Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2023; 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.