Individual provider Active NPI

Myron Cornel Stokes, M.D.

  • Surgery Physician
  • Cordova, TN
National Provider Identifier
1982613683
Registry record updated Sep 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
21733 Issued in MS
Practice address
1143 Cully Rd
Cordova, TN 38018-8502
Phone
(615) 484-8128
Fax
(901) 328-5599
NPI assigned
Aug 5, 2006
Last updated
Sep 25, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X 21733 MS
Surgery Physician 208600000X 21733 MS Primary

Addresses

Primary practice location

1143 Cully Rd
Cordova, TN 38018-8502

Mailing address

PO Box 1562
Collierville, TN 38027-1562
Phone (901) 316-5648

Other identifiers 6

IdentifierTypeStateIssuer
01262457OtherTNAMERIGROUP
4212217OtherTNMEDICARE ADVANTAGE
4212217OtherTNBCBS TN
1510428MedicaidTN
20350091323OtherTNAMERICHOICE
5108599OtherTNCIGNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MS2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20061010000094 TN Practitioner - General SurgeryPractitioner - General Practice 1254337520 Reassigns benefits to 1 organization
I20111003000390 MS Practitioner - General SurgeryPractitioner - General Practice 1254337520 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: General Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Health Providers of America LLCGroup PAC ID 9931529948, 97 clinicians

Practice addresses (Care Compare)

1730 Dorchester Dr
Southaven, MS 38671-5723
Phone (662) 393-0050

928 Old Smithville Rd
McMinnville, TN 37110-6805
Phone (931) 473-8431

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue180

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
21733MSMDAdult Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Health Providers of America, LLC CurrentSince Apr 20, 2021 Accepting new patients
Clarksville Physician Services LLC Surgery Past Accepting new patients
Grenada Lake Medical Center Past Accepting new patients
Tishomingo Health Services, Inc. Past Accepting new patients
Tennessee Heart and Lung Institute PLC Past Accepting new patients
Norton Community Physician Services LLC Past Accepting new patients
Norton Community Physician Services LLC Past Accepting new patients

Locations

111 Chase St
Byhalia, MS 38611
Phone (662) 252-1141

1730 Dorchester Dr
Southaven, MS 38671
Phone (662) 226-2442

1025 Crestway Dr
Athens, TN 37303
Phone (423) 453-4721

200 Sanitarium Cir
Dayton, TN 37321
Phone (423) 775-0771

928 Old Smithville Rd
McMinnville, TN 37110
Phone (931) 473-8431

3549 Norriswood Ave
Memphis, TN 38111
Phone (864) 671-0600

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1879/brand/1/csg/1/fhir/r4

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695600000000",
    "number": "1982613683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1562",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380271562",
            "telephone_number": "901-316-5648",
            "fax_number": "901-221-8070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1143 CULLY RD",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380188502",
            "telephone_number": "615-484-8128",
            "fax_number": "901-328-5599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOKES",
        "first_name": "MYRON",
        "middle_name": "CORNEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "MS",
            "license": "21733",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MS",
            "license": "21733",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "01262457",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ADVANTAGE",
            "identifier": "4212217",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TN",
            "identifier": "4212217",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1510428",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE",
            "identifier": "20350091323",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "5108599",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cordova, TN

Sources for this page

Verify at the official NPI Registry.