Southeast Regional Medical Solutions, PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

SOUTHEAST REGIONAL MEDICAL SOLUTIONS, PLLC

Practice address

2506 Lakeland Dr Ste 310
Flowood, MS 39232-7640

Phone

(769) 487-6036

NPI assigned

May 24, 2019

Organization subpart

No

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

Authorized official

Name

Micheal L Bookhardt, MD

Title

Owner

Phone

(321) 229-8868

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Locations

Practitioners 1

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

• Michael Bookhardt, M.D.

  • Family Medicine Physician
  • Flowood, MS
  • NPI 1881034254
  Medicare reassignment NPD

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

{
    "created_epoch": "1558656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709510400000",
    "number": "1780241729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 RIVER FOREST LN",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390477020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2506 LAKELAND DR STE 310",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392327640",
            "telephone_number": "769-487-6036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST REGIONAL MEDICAL SOLUTIONS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-24",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-04",
        "status": "A",
        "authorized_official_last_name": "BOOKHARDT",
        "authorized_official_first_name": "MICHEAL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "321-229-8868",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Flowood, MS
• Providers in Flowood, 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 Mar 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.