Gregory Thomas Stallworth, MD is a medicare enrolled "Emergency Medicine" physician in Holly Springs, Mississippi. He went to Meharry Medical College School Of Medicine and graduated in 1978 and has 46 years of diverse experience with area of expertise as Emergency Medicine. He is a member of the group practice Alliance Healthcare System, Inc and his current practice location is
1430 Hwy 4-east, Holly Springs, Mississippi. You can reach out to his office (for appointments etc.) via phone at
(662) 551-3369.
Gregory Thomas Stallworth is licensed to practice in Mississippi (license number 00578) and he also participates in the medicare program. He
may accept medicare assignments (which means he may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and his NPI Number is 1043314057.
Physician's Profile
| Full Name | Gregory Thomas Stallworth |
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| Gender | Male |
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| Speciality | Emergency Medicine |
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| Experience | 46 Years |
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| Location | 1430 Hwy 4-east, Holly Springs, Mississippi |
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| Accepts Medicare Assignments | May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Gregory Thomas Stallworth attended and graduated from Meharry Medical College School Of Medicine in 1978
NPI Data:
- NPI Number: 1043314057
- Provider Enumeration Date: 09/11/2006
- Last Update Date: 07/08/2007
Medicare PECOS Information:
- PECOS PAC ID: 6204909708
- Enrollment ID: I20080716000640
Medical Identifiers
Medical identifiers for Gregory Thomas Stallworth such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1043314057 | NPI | - | NPPES |
| 00116623 | Medicaid | MS | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207P00000X | Emergency Medicine | 00578 (Mississippi) | Primary |
Medical Facilities Affiliation
| Facility Name | Location | Facility Type |
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| Kindred At Home | Tupelo, MS | Home health agency |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Alliance Healthcare System, Inc | 2961489547 | 4 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Gregory Thomas Stallworth allows following entities to bill medicare on his behalf.
| Entity Name | Alliance Healthcare System, Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1821143256
PECOS PAC ID: 2961489547
Enrollment ID: O20040701000719 |
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| Entity Name | Coffee County Physician Group Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1437164878
PECOS PAC ID: 4082671235
Enrollment ID: O20190612002779 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Gregory Thomas Stallworth is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Gregory Thomas Stallworth, MD
1430 Hwy 4-east, P.o. Box 6000,
Holly Springs, MS 38634
Ph: (662) 551-3369 | Gregory Thomas Stallworth, MD
1430 Hwy 4-east,
Holly Springs, MS 38634
Ph: (662) 551-3369 |
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