Individual provider Active NPI

Brendan Williams, DO

  • Internal Medicine Physician
  • Southaven, MS
National Provider Identifier
1932588407
Registry record updated Mar 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
26703 Issued in MS
Practice address
7601 Southcrest Pkwy
Southaven, MS 38671-4739
Phone
(662) 772-2980
Fax
(662) 772-2960
NPI assigned
May 29, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X E-13921 AR
Internal Medicine Physician 207R00000X 3718 TN
Internal Medicine Physician 207R00000X OS15264 FL
Internal Medicine Physician 207R00000X 26703 MS Primary

Addresses

Primary practice location

7601 Southcrest Pkwy
Southaven, MS 38671-4739

Mailing address

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

Other practice location 1

6019 Walnut Grove Rd
Memphis, TN 38120-2113
Phone (901) 226-3610

Other practice location 2

2100 N 7th St
West Memphis, AR 72301-2017
Phone (901) 226-3610

Other identifiers 1

IdentifierTypeStateIssuer
024944600MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, TN, AR3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20190618001351 MS Practitioner - Internal Medicine 4082921291 Reassigns benefits to 2 organizations
I20191008000320 TN Practitioner - Internal Medicine 4082921291 Reassigns benefits to 1 organization
I20210318002583 AR Practitioner - Internal Medicine 4082921291 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Lincoln Mem Univ, Debusk Col of Osteopathic Med, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Intensivist Services PCGroup PAC ID 9335152107, 234 clinicians
Southeastern Physician Services PCGroup PAC ID 0042307852, 591 clinicians

Practice addresses (Care Compare)

2100 N 7TH St
West Memphis, AR 72301-2017
Phone (901) 226-3610

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

4800 E Johnson Ave
Jonesboro, AR 72405-8413
Phone (870) 936-1000

4802 E Johnson Ave
Jonesboro, AR 72405-8413
Phone (901) 227-9820

6019 Walnut Grove Rd
Memphis, TN 38120-2113
Phone (901) 226-5000

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

Hospital & facility affiliations

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 Osteopathy

State licenses

LicenseStateTypeSpecialty
E-13921ARMDInternal Medicine Physician
OS15264FLMDInternal Medicine Physician
26703MSMDInternal Medicine Physician
3718TNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Memorial Medical Group Inc Internal Medicine CurrentSince Jul 1, 2019 Accepting new patients
Southeastern Intensivist Services PC Internal Medicine CurrentSince Oct 1, 2025 Accepting new patients
Greenbrook Physician Services, LLC Internal Medicine CurrentSince Oct 1, 2025 Accepting new patients
Baptist Memorial Medical Group Inc CurrentSince Jul 1, 2019 Accepting new patients

Locations

4802 E Johnson Ave
Jonesboro, AR 72405
Phone (901) 227-9820

2100 N 7th St
West Memphis, AR 72301
Phone (870) 394-7800

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

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

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

6019 Walnut Grove Rd
Memphis, TN 38120
Phone (901) 226-3190

Interoperability endpoints

  • Direct secure messaging: bwilliams248895@direct.bmhcc.org

Organizations & group practices 5

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 3

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": "1432857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615507200000",
    "number": "1932588407",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7601 SOUTHCREST PKWY",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386714739",
            "telephone_number": "662-772-2980",
            "fax_number": "662-772-2960"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6019 Walnut Grove Rd",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381202113",
            "country_code": "US",
            "telephone_number": "901-226-3610",
            "fax_number": "901-226-3612",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2100 N 7th St",
            "address_purpose": "LOCATION",
            "city": "West Memphis",
            "state": "AR",
            "postal_code": "723012017",
            "country_code": "US",
            "telephone_number": "901-226-3610",
            "fax_number": "901-226-3612",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "BRENDAN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-29",
        "last_updated": "2021-03-12",
        "certification_date": "2021-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "E-13921",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "3718",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS15264",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "26703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "024944600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southaven, MS

Sources for this page

Verify at the official NPI Registry.