Active NPI
Rachael Ehimudiamen Agbator, MD
- Internal Medicine Physician
- Tupelo, MS
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 33819
- Practice address
- 830 S Gloster St
Tupelo, MS 38801-4934 - Phone
- (662) 377-2539
- NPI assigned
- Jun 11, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Internal Medicine Physician | 207R00000X | 33819 | MS | Primary |
Addresses
Primary practice location
830 S Gloster St
Tupelo, MS 38801-4934
Mailing address
808 Varsity Dr
Tupelo, MS 38801-4613
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR, MS
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
830 S Gloster St
Tupelo, MS 38801-4934
Phone (662) 377-3000
Hospital & facility affiliations
- North Mississippi Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 92.62 of 100
- Quality
- 88.22
- Promoting interoperability
- 77
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33819 | MS | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| HCC of El Dorado LLC | Current | Accepting new patients | |
| Ess of El Dorado, LLC | Current | Accepting new patients | |
| North Mississippi Medical Center Inc. | Internal Medicine | Current | Accepting new patients |
| North Mississippi Medical Center | Current | Accepting new patients | |
| North Mississippi Medical Center Inc | Current | Accepting new patients | |
| North Mississippi Medcial Center, Inc. | Current | Accepting new patients | |
| North Mississippi Medical Center, Inc. | Past | Accepting new patients |
Locations
700 W Grove St
El Dorado, AR 71730
Phone (870) 863-2200
808 Varsity Dr
Tupelo, MS 38801
Phone (662) 377-2386
830 S Gloster St
Tupelo, MS 38801
Phone (662) 377-3136
Interoperability endpoints
- rachaelagbator@nmhs.medalliesdirect.net
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 and National Provider Directory roles.
-
- Psychologist
- Tupelo, MS
- NPI 1972608347
-
- Emergency Medicine Physician
- El Dorado, AR
- NPI 1861851131
-
- Hospitalist Physician
- El Dorado, AR
- NPI 1003578725
-
- Diagnostic Radiology Physician
- Tupelo, MS
- NPI 1902762487
-
- General Acute Care Hospital
- Tupelo, MS
- NPI 1376969683
-
- Internal Medicine Physician
- Tupelo, MS
- NPI 1609243351
-
- General Acute Care Hospital
- Tupelo, MS
- NPI 1598875460
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Tupelo, MS
- NPI 1598875460
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623369600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723507200000",
"number": "1831767490",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "808 VARSITY DR",
"city": "TUPELO",
"state": "MS",
"postal_code": "388014613"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "830 S GLOSTER ST",
"city": "TUPELO",
"state": "MS",
"postal_code": "388014934",
"telephone_number": "662-377-2539"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AGBATOR",
"first_name": "RACHAEL",
"middle_name": "EHIMUDIAMEN",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-06-11",
"last_updated": "2024-08-13",
"certification_date": "2024-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MS",
"license": "33819",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tupelo, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2024; 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.