NPIMap

Individual provider Active NPI

Michael Kim Ko, M.D.

  • Specialist
  • Greenwood, MS
National Provider Identifier
1821127804
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
17150 Issued in MS
Practice address
1401 River Rd
Greenwood, MS 38930-4030
Phone
(662) 459-7000
NPI assigned
Mar 5, 2007
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 17150 MS Primary

Addresses

Primary practice location

1401 River Rd
Greenwood, MS 38930-4030

Mailing address

PO Box 10117
Greenwood, MS 38930-0117
Phone (662) 455-9595

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17150MSMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Sunder Jagwani MD PA Single Specialty Current Accepting new patients
State of Mississippi - University of Mississippi Medical Center Single Specialty Current Accepting new patients
Radiology Associates of Houston County Single Specialty Past Accepting new patients
Ko, Michael Specialist PastSince Apr 3, 2004 Accepting new patients
Houston Hospitals Inc Single Specialty Past Accepting new patients
Magnolia Surgery, PC Single Specialty Past Accepting new patients

Locations

1401 River Rd
Greenwood, MS 38930
Phone (662) 459-2603

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1821127804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10117",
            "city": "GREENWOOD",
            "state": "MS",
            "postal_code": "389300117",
            "telephone_number": "662-455-9595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 RIVER RD",
            "city": "GREENWOOD",
            "state": "MS",
            "postal_code": "389304030",
            "telephone_number": "662-459-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KO",
        "first_name": "MICHAEL",
        "middle_name": "KIM",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-05",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MS",
            "license": "17150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, MS

Sources for this page

Verify at the official NPI Registry.