Organization Active NPI

Internal Medicine Specialists PLLC

  • Internal Medicine Physician
  • Flowood, MS
National Provider Identifier
1740909464
Registry record updated Feb 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
INTERNAL MEDICINE SPECIALISTS PLLC
Practice address
1040 River Oaks Dr Ste 201
Flowood, MS 39232-9534
Phone
(601) 992-1222
Fax
(601) 992-7222
NPI assigned
Aug 25, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2023

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

Authorized official

Name
Stephanie Thompson
Title
Office Manager
Phone
(601) 992-1222

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

1040 River Oaks Dr Ste 201
Flowood, MS 39232-9534

Mailing address

1040 River Oaks Dr Ste 201
Flowood, MS 39232-9534
Phone (601) 992-1222

Other names 2

  • Internal Medicine Specialists PLLC Doing business as
  • Internal Medicine Specialist PLLC Other name

Electronic endpoints 2

TypeEndpointUseAffiliation
SOAP URL Portal Health Information Exchange (HIE)
SOAP URL TSI Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230201002463 MS Part B Supplier - Clinic/Group Practice 1355713249 Receives reassigned benefits from 5 practitioners
Practice locations: Flowood, MS

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
25D2276911Internal Medicine Specialists1040 River Oaks Dr Ste 201, Flowood, MS 39232Certificate of waiverFeb 15, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1661385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676246400000",
    "number": "1740909464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 RIVER OAKS DR STE 201",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329534",
            "telephone_number": "601-992-1222",
            "fax_number": "601-992-7222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 RIVER OAKS DR STE 201",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329534",
            "telephone_number": "601-992-1222",
            "fax_number": "601-992-7222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNAL MEDICINE SPECIALISTS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-25",
        "last_updated": "2023-02-13",
        "certification_date": "2023-02-13",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "601-992-1222"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Portal",
            "affiliation": "N",
            "endpointDescription": "Portal",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "971 Lakeland Dr Ste 950",
            "city": "Jackson",
            "state": "MS",
            "country_code": "US",
            "postal_code": "392164608",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "TSI",
            "affiliation": "N",
            "endpointDescription": "TSI",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "971 Lakeland Dr Ste 950",
            "city": "Jackson",
            "state": "MS",
            "country_code": "US",
            "postal_code": "392164608",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Internal Medicine Specialists PLLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Internal Medicine Specialist PLLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Flowood, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2023; 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.