Individual provider Active NPI

George Sean Tucker, M.D.

  • Obstetrics & Gynecology Physician
  • Southaven, MS
National Provider Identifier
1780764290
Registry record updated May 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
22162 Issued in MS
Practice address
401 Southcrest Cir Ste 104
Southaven, MS 38671-6712
Phone
(662) 349-1112
Fax
(662) 772-2688
NPI assigned
Oct 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X GA-055033 GA
Obstetrics & Gynecology Physician 207V00000X 22162 MS Primary
Obstetrics & Gynecology Physician 207V00000X 47823 TN

Addresses

Primary practice location

401 Southcrest Cir Ste 104
Southaven, MS 38671-6712

Mailing address

965 Ridge Lake Blvd Ste 103
Memphis, TN 38120-9446

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, TN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20130322000045 MS Practitioner - Obstetrics/Gynecology 3779542253 Reassigns benefits to 2 organizations
I20200602000658 TN Practitioner - Obstetrics/Gynecology 3779542253 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Morehouse School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist Memorial Medical Group, Inc.Group PAC ID 5193610228, 581 clinicians
Obhg Mississippi PCGroup PAC ID 7416120407, 29 clinicians

Practice addresses (Care Compare)

255 Baptist Blvd
Columbus, MS 39705-2006

36 Capital Way
Suite E
Atoka, TN 38004-7986
Phone (901) 837-6801

401 Southcrest Cir
Suite 104
Southaven, MS 38671-6712
Phone (662) 349-1112

7601 Southcrest Pkwy
Southaven, MS 38671-4739
Phone (662) 772-2130

8138 Country Village Dr
Cordova, TN 38016-2029
Phone (901) 725-8606

PO Box
Suite 405827
Atlanta, GA 30384-5827

Hospital & facility affiliations

  • Baptist Memorial Hospital Desoto Hospital, Southaven, MS, CCN 250141

Merit-based Incentive Payment System (MIPS)

Final score
81.87 of 100Reported as group
Quality
64.75
Promoting interoperability
100
Improvement activities
40
Cost
74.81

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
GA-055033GAMDObstetrics & Gynecology Physician
22162MSMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Memorial Medical Group Inc Obstetrics & Gynecology CurrentSince May 31, 2020 Accepting new patients
Baptist Memorial Medical Group Inc CurrentSince May 31, 2020 Accepting new patients
Obhg Mississippi, P.C. Obstetrics & Gynecology CurrentSince Sep 25, 2020 Accepting new patients
Baptist Memorial Hospital-Desoto, Inc, Past Accepting new patients

Locations

255 Baptist Blvd
Ste 301
Columbus, MS 39705
Phone (662) 244-2288

1225 N State St
Jackson, MS 39202
Phone (601) 292-4261

7601 Southcrest Pkwy
Southaven, MS 38671
Phone (662) 349-4000

401 Southcrest Cir
Ste 104
Southaven, MS 38671
Phone (662) 349-1112

7736 Airways Blvd
Southaven, MS 38671
Phone (662) 772-3700

36 Capital Way
Ste E
Atoka, TN 38004
Phone (901) 837-6801

965 Ridge Lake Blvd
Ste 103
Memphis, TN 38120
Phone (901) 227-3221

8040 Wolf River Blvd
Ste 103
Memphis, TN 38138
Phone (901) 725-8606

2100 Exeter Rd
Memphis, TN 38138
Phone (901) 757-1350

Interoperability endpoints

  • Direct secure messaging: gtucker14980@direct.bmhcc.org
  • Direct secure messaging: tucker_george_md@yourcarecommunity.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589241600000",
    "number": "1780764290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 RIDGE LAKE BLVD STE 103",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381209446",
            "fax_number": "901-227-8591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 SOUTHCREST CIR STE 104",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386716712",
            "telephone_number": "662-349-1112",
            "fax_number": "662-772-2688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "GEORGE",
        "middle_name": "SEAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2020-05-12",
        "certification_date": "2020-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "GA-055033",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MS",
            "license": "22162",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TN",
            "license": "47823",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southaven, MS

Sources for this page

Verify at the official NPI Registry.