Chip D Holbrook, MD
Individual provider Active NPI Family Medicine Physician · Mendenhall, MS
NPI 1962546192 · NPPES record last updated Apr 17, 2008
Key facts
- NPI
- 1962546192
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 14412 (MS)
- Practice address
- 102 Oak St
Mendenhall, MS 39114-3650 - Phone
- (601) 847-3712
- NPI assigned
- Feb 19, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 9
Hospital & facility affiliations 13
Owned or controlled facilities with NPI records 1
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of Mississippi School of Medicine, 1994
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Simpson Community Healthcare, Inc.
Practice addresses (Care Compare)
1827C Simpson Hwy 149
Mendenhall, MS 39114-3439
Phone (601) 847-2424
Hospital & facility affiliations
- Sta Home Health Agency of Jackson, Inc. Dba Accentcare Home Health of Jackson
- Mississippi Homecare of Jackson
- Centerwell Home Health
- Enhabit Home Health
- Pax Hospice
- Simpson General Hospital Cah
- Magee General Hospital
- Covington County Hospital Cah
- St Dominic-Jackson Memorial Hospital
- South Central Reg Med Ctr
- Hillcrest Nursing Center
- Bedford Care Center of Mendenhall
- Simpson General Hospital Cah
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| Hillcrest Nursing Center |
Skilled nursing facility | Operational/Managerial Control Adp of the SNF |
Jan 19, 2022 Jan 19, 2022 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080722000156 | MS | Practitioner - Family Practice | 2769555960 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14412 | MS | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Simpson Community Healthcare, Inc. | Current | Accepting new patients | |
| Simpson Community Healthcare, Inc | Current |
Accepting new patients | |
| Simpson Community Healthcare Inc. | Current |
Accepting new patients | |
| Magee Community Care Center LLC | Past |
Accepting new patients | |
| Simpson Community Healthcare, Inc | Past | Accepting new patients | |
| Bedford Care Center of Mendenhall, LLC | Past | Accepting new patients |
Locations
102 Oak St
Mendenhall, MS 39114
Phone (601) 847-3712
1842 Simpson Highway 149
Mendenhall, MS 39114
Phone (601) 847-2221
1827C Simpson Highway 149
Mendenhall, MS 39114
Phone (601) 847-2424
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 14412 | MS | Yes |
Addresses
Primary practice location
102 Oak St
Mendenhall, MS 39114-3650
Mailing address
102 Oak St
Mendenhall, MS 39114-3650
Phone (601) 847-3712
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00115198 | Medicaid | MS | |
| 09015830 | Medicaid | MS |
Other providers in Mendenhall, MS
- Melissa Lynn Fortenberry
- Melissa Lashell Green
- Lakesha Hayes
- Anna Hewitt
- Holbrook Family Medical Practice, Inc.
- Jason Holloway
- Kiara S Hubbard
- Bobbie Hughes
- Amy Jenkins
- Penelope Jones
All providers in Mendenhall, MS · Family Medicine Physician in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 17, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.