Family Medicine Residency Center - Medicare Primary Care in Tupelo, MS

Family Medicine Residency Center is a medicare enrolled primary clinic (Family Medicine) in Tupelo, Mississippi. The current practice location for Family Medicine Residency Center is 1665 S Green St, Tupelo, Mississippi. For appointments, you can reach them via phone at (662) 377-2189. The mailing address for Family Medicine Residency Center is 1665 S Green St, Tupelo, Mississippi and phone number is (662) 377-2189.

Family Medicine Residency Center is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1255692356. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (662) 377-2189.

Contact Information

Family Medicine Residency Center
1665 S Green St
Tupelo
MS 38804-6556
(662) 377-2189
(662) 377-2263

Map and Direction


Primary Care Clinic Profile

Full NameFamily Medicine Residency Center
SpecialityFamily Medicine
Location1665 S Green St, Tupelo, Mississippi
Authorized Official Name and PositionGerald Kimbrough (DIRECTOR)
Authorized Official Contact6623774685
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Family Medicine Residency Center
1665 S Green St
Tupelo
MS 38804-6556

Ph: (662) 377-2189
Family Medicine Residency Center
1665 S Green St
Tupelo
MS 38804-6556

Ph: (662) 377-2189

NPI Details:

NPI Number1255692356
Provider Enumeration Date06/05/2012
Last Update Date05/06/2019

Medicare PECOS Information:

Medicare PECOS PAC ID2961658950
Medicare Enrollment IDO20120807000540

Medical Identifiers

Medical identifiers for Family Medicine Residency Center such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1255692356NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Family Medicine Residency Center acts as a billing entity for following providers:
Provider NameDavid J Brooks
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1962440214
PECOS PAC ID: 7719953074
Enrollment ID: I20040908000608
Provider NameDennis E Smith
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1245279918
PECOS PAC ID: 6406854959
Enrollment ID: I20061117000315
Provider NameTerry R Perrine
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1033157391
PECOS PAC ID: 9234269424
Enrollment ID: I20100615000408
Provider NameGina Smith
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1629580642
PECOS PAC ID: 8022374768
Enrollment ID: I20171113001536
Provider NameWilliam P Davis
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1407237365
PECOS PAC ID: 8224325592
Enrollment ID: I20180626002065
Provider NameTerri Jo Teague
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1255719415
PECOS PAC ID: 5294168019
Enrollment ID: I20191210001359
Provider NameEthan Tillotson
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1194175273
PECOS PAC ID: 8224323183
Enrollment ID: I20200526003086
Provider NameLeslie Smothers
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1851706477
PECOS PAC ID: 6103113162
Enrollment ID: I20200805003109
Provider NameAugusto Soltero
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1346407814
PECOS PAC ID: 4688702665
Enrollment ID: I20200903001808
Provider NameDenaya Conley
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1952808958
PECOS PAC ID: 4082015995
Enrollment ID: I20221004000504

Reviews and Comments


Family Medicine in Tupelo, MS

South Madison Medical Clinic
Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 1040a S. Madison St, Tupelo, MS 38801
Phone: 662-377-4685    Fax: 662-377-2755
Nmmc Ekg Interpretations
Primary Care Clinic
Medicare: Medicare Enrolled
Practice Location: 830 S Gloster St, Tupelo, MS 38801
Phone: 662-377-4685    Fax: 662-377-2755
North Mississippi Neurosurgical Services
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Medicare: Not Enrolled in Medicare
Practice Location: 4381 S Eason Blvd, Suite 302, Tupelo, MS 38801
Phone: 662-377-5700    Fax: 662-377-5720
Pontotoc Health Providers
Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 450 E President Ave, Tupelo, MS 38801
Phone: 662-377-4685    Fax: 662-377-2057
Grant Family Medical Llc
Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 805 Varsity Dr, Tupelo, MS 38801
Phone: 484-252-6707    
North Mississippi Medical Clinics Inc
Primary Care Clinic
Medicare: Medicare Enrolled
Practice Location: 450 E President Ave, Tupelo, MS 38801
Phone: 662-377-4685    
Advanced Wound Center Professionals
Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 830 S Gloster St, 1st Floor East Tower, Tupelo, MS 38801
Phone: 662-377-2395    Fax: 662-377-2397

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.