Individual provider Active NPI

Curtis Scott Childress, MD

  • Otolaryngology Physician
  • Hattiesburg, MS
National Provider Identifier
1922069921
Registry record updated Aug 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
16507 Issued in MS
Practice address
107 Millsaps Dr
Hattiesburg, MS 39402
Phone
(601) 268-5131
Fax
(601) 268-5138
NPI assigned
Mar 29, 2006
Last updated
Aug 25, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 16507 MS Primary
Otolaryngic Allergy Physician 207YX0602X 16507 MS
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X 16507 MS

Addresses

Primary practice location

107 Millsaps Dr
Hattiesburg, MS 39402

Mailing address

107 Millsaps Dr
Hattiesburg, MS 39402-1348
Phone (601) 268-5131

Other identifiers 1

IdentifierTypeStateIssuer
007270080MedicaidMS

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040212000223 MS Practitioner - Otolaryngology 7911891668 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Mississippi School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wesley Physician Services LLCGroup PAC ID 2466559851, 42 clinicians

Practice addresses (Care Compare)

107 Millsaps Dr
Hattiesburg, MS 39402-1348
Phone (601) 268-5131

5001 Hardy St
Hattiesburg, MS 39402-1308
Phone (601) 268-8155

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.07 of 100Reported as apm
Quality
73.89
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15507MSMDObstetrics Physician
16507MSMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wesley Physician Services LLC CurrentSince Jun 20, 2020 Accepting new patients
Golden Triangle Outpatient Center LLC PastSince Aug 4, 2024 Accepting new patients
Head and Neck Surgery Center, LLC PastSince Jan 1, 2017 Accepting new patients

Locations

107 Millsaps Dr
Hattiesburg, MS 39402
Phone (601) 268-5131

5001 Hardy St
Hattiesburg, MS 39402
Phone (601) 268-8000

Interoperability endpoints

  • Direct secure messaging: curtis.childress.1@1930.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/1930/brand/2/csg/102/fhir/r4

Organizations & group practices 3

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.

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": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598313600000",
    "number": "1922069921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 MILLSAPS DR",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021348",
            "telephone_number": "601-268-5131",
            "fax_number": "601-268-5138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 MILLSAPS DR",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "39402",
            "telephone_number": "601-268-5131",
            "fax_number": "601-268-5138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHILDRESS",
        "first_name": "CURTIS",
        "middle_name": "SCOTT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-29",
        "last_updated": "2020-08-25",
        "certification_date": "2020-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MS",
            "license": "16507",
            "primary": true
        },
        {
            "code": "207YX0602X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngic Allergy",
            "state": "MS",
            "license": "16507",
            "primary": false
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "MS",
            "license": "16507",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007270080",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

Verify at the official NPI Registry.