Lakeisha Renae Chism, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

23963 Issued in MS

Practice address

1665 S Green St
Tupelo, MS 38804-6556

Phone

(662) 377-2189

NPI assigned

Jun 17, 2013

Last updated

Oct 5, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Family Practice

Education

Meharry Medical College School of Medicine, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Mississippi Medical Clinics IncGroup PAC ID 6103736665, 120 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• North Mississippi Medical Ctr HHA Home health agency, Tupelo, MS, CCN 257002
• North Mississippi Medical Center Hospital, Tupelo, MS, CCN 250004

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lakeishachism@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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• North Mississippi Medical Clinics Inc

  • Internal Medicine Physician
  • Tupelo, MS
  • NPI 1053469486

  Family Medicine

  Medicare reassignment Care Compare group NPD
• North Mississippi Medical Center

  • General Acute Care Hospital
  • Tupelo, MS
  • NPI 1376969683
  NPD
• North Mississippi Medical Clinics Inc

  dba Pulmonary Consultants

  • Pulmonary Disease Physician
  • Tupelo, MS
  • NPI 1104937143
  NPD
• North Mississippi Medical Clinics Inc

  dba The Women's Group West Point

  • Obstetrics & Gynecology Physician
  • West Point, MS
  • NPI 1588769970
  NPD

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

• North Mississippi Medical Center, Inc.

  dba North MS Medical Center Home Health Agency

  • Home Health Agency
  • Tupelo, MS
  • NPI 1003871344
  Care Compare affiliation
• North Mississippi Medical Center, Inc.

  dba North Mississippi Medical Center

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

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

{
    "created_epoch": "1371427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507161600000",
    "number": "1750720363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1665 S GREEN ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388046556",
            "telephone_number": "662-377-2189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1665 S GREEN ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388046556",
            "telephone_number": "662-377-2189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHISM",
        "first_name": "LAKEISHA",
        "middle_name": "RENAE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-17",
        "last_updated": "2017-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "23963",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04003571",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Scott Childers, PT, DPT
• Children's Clinic of Tupelo, PA
• Children's Dental Clinic, PA (Children's Dental Clinic)
• Jessica Braddock Childs, AGNP
• David J Chisholm, CRNA
• Suzanne Chittom, M.S., OTR/L
• Leslie Chrestman, M.ED
• James Leland Chrisman, D.D.S.
• Ashley Christian, M.ED.
• Athena Tiwari Christman, MD

• Family Medicine Physician in Tupelo, MS
• Providers in Tupelo, MS by specialty
• Family Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2017; 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.