NPIMap

Individual provider Active NPI

David James Brooks, MD

  • Family Medicine Physician
  • Tupelo, MS
National Provider Identifier
1962440214
Registry record updated Oct 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
14205 Issued in MS
Practice address
1665 S Green St
Tupelo, MS 38804-6556
Phone
(662) 377-2189
Fax
(662) 377-2263
NPI assigned
Jun 2, 2006
Last updated
Oct 19, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 14205 MS Primary

Addresses

Primary practice location

1665 S Green St
Tupelo, MS 38804-6556

Mailing address

450 E President Ave
Tupelo, MS 38801-5599
Phone (662) 377-2189

Other identifiers 1

IdentifierTypeStateIssuer
00115614MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040908000608 MS Practitioner - Family Practice 7719953074 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Mississippi Faculty Practice Plan LLCGroup PAC ID 2961658950, 8 clinicians

Practice addresses (Care Compare)

1665 S Green St
Tupelo, MS 38804-6556
Phone (662) 377-2189

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14205MSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Mississippi Faculty Practice Plan LLC Family Medicine CurrentSince Jul 1, 2012 Accepting new patients
North Mississippi Medical Center Current Accepting new patients
Pontotoc Health Services, Inc. CurrentSince Oct 25, 2018 Accepting new patients
Pontotoc Health Services, Inc. CurrentSince Oct 25, 2018 Accepting new patients
Tishomingo Health Services, Inc. Past Accepting new patients
United Emergency Services, Inc. Past Accepting new patients
Columbus Emergency Services, LLC Past Accepting new patients
Baptist Memorial Health Services Inc of Mississippi Past Accepting new patients
North Ms Emergency Physicians Past Accepting new patients
North Mississippi Faculty Practice Family Medicine Past Accepting new patients

Locations

176 S Main St
Pontotoc, MS 38863
Phone (601) 489-5510

1665 S Green St
Tupelo, MS 38804
Phone (662) 377-2189

830 S Gloster St
Tupelo, MS 38801
Phone (662) 377-3136

Interoperability endpoints

  • Direct secure messaging: davidbrooks@nmhs.medalliesdirect.net

Organizations & group practices 10

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": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192752000000",
    "number": "1962440214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 E PRESIDENT AVE",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388015599",
            "telephone_number": "662-377-2189",
            "fax_number": "662-377-2263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1665 S GREEN ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388046556",
            "telephone_number": "662-377-2189",
            "fax_number": "662-377-2263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "DAVID",
        "middle_name": "JAMES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2007-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "14205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00115614",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tupelo, MS

Sources for this page

Verify at the official NPI Registry.