NPIMap

Individual provider Active NPI

Chip D Holbrook, MD

  • Family Medicine Physician
  • Mendenhall, MS
National Provider Identifier
1962546192
Registry record updated Apr 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
14412 Issued in MS
Practice address
102 Oak St
Mendenhall, MS 39114-3650
Phone
(601) 847-3712
NPI assigned
Feb 19, 2007
Last updated
Apr 17, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2008

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 14412 MS Primary

Addresses

Primary practice location

102 Oak St
Mendenhall, MS 39114-3650

Mailing address

102 Oak St
Mendenhall, MS 39114-3650
Phone (601) 847-3712

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
I20080722000156 MS Practitioner - Family Practice 2769555960 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Mississippi School of Medicine, 1994
Medicare assignment
May accept Medicare assignment
Group practices

Practice addresses (Care Compare)

1827C Simpson Hwy 149
Mendenhall, MS 39114-3439
Phone (601) 847-2424

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Simpson Community Healthcare, Inc. Current Accepting new patients
Simpson Community Healthcare, Inc CurrentSince Jan 1, 2010 Accepting new patients
Simpson Community Healthcare Inc. CurrentSince Jan 1, 2010 Accepting new patients
Magee Community Care Center LLC PastSince Jan 19, 2022 Accepting new patients
Bedford Care Center of Mendenhall, LLC Past Accepting new patients
Simpson Community Healthcare, Inc Past Accepting new patients

Locations

102 Oak St
Mendenhall, MS 39114
Phone (601) 847-3712

1827C Simpson Highway 149
Mendenhall, MS 39114
Phone (601) 847-2424

1842 Simpson Highway 149
Mendenhall, MS 39114
Phone (601) 847-2221

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Hillcrest Nursing CenterMagee, MS, CCN 255278 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 19, 2022
Jan 19, 2022

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208390400000",
    "number": "1962546192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 OAK ST",
            "city": "MENDENHALL",
            "state": "MS",
            "postal_code": "391143650",
            "telephone_number": "601-847-3712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 OAK ST",
            "city": "MENDENHALL",
            "state": "MS",
            "postal_code": "391143650",
            "telephone_number": "601-847-3712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLBROOK",
        "first_name": "CHIP",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-19",
        "last_updated": "2008-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "14412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mendenhall, MS

Sources for this page

Verify at the official NPI Registry.