Amos Belknap, MD
Individual provider Active NPI Family Medicine Physician · Pearl, MS
NPI 1972527372 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1972527372
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 05956 (MS)
- Practice address
- 342 Gilchrist Dr
Pearl, MS 39208-6671 - Phone
- (601) 939-0700
- Fax
- (601) 939-8654
- NPI assigned
- Jul 27, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110104000713 | MS | Practitioner - Family Practice | 0648259374 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05956 | MS | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| First Intermed Corporation | Family Medicine | Past | Accepting new patients |
| First Intermed Corporation | Family Medicine | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 05956 | MS | Yes |
Addresses
Primary practice location
342 Gilchrist Dr
Pearl, MS 39208-6671
Mailing address
342 Gilchrist Dr
Pearl, MS 39208-6671
Phone (601) 939-0700
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0122356 | Medicaid | MS |
Other providers in Pearl, MS
- Edgar D. Barham Jr.
- Devona D Barlow
- Sajani Barot
- Vishal Barot
- Nikesia Beamon-Webb
- Richard Adam Bell
- Benemed Holdings, Inc.
- Alexandra Morris Benoit
- Laurel Bland
- Kimberly Renee Blumenberg
All providers in Pearl, 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 Jul 8, 2007. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.