John M Abide, MD
Individual provider Active NPI Specialist · Greenville, MS
NPI 1992704530 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1992704530
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- 06972 (MS)
- Practice address
- 1209 S Main St
Greenville, MS 38701-6342 - Phone
- (662) 335-3847
- NPI assigned
- Jul 15, 2005
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 06972 | MS | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Internal Medicine Assoc LLP | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 06972 | MS | Yes |
Addresses
Primary practice location
1209 S Main St
Greenville, MS 38701-6342
Mailing address
481 Cypress LN
Apt. A103
Greenville, MS 38701-7473
Phone (662) 332-3391
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0013892 | Medicaid | MS |
Other providers in Greenville, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 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.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.