Dr Vivian Elizabeth 'lisa' Huddleston, MD - Medicare Pediatrics in Greenwood, MS

Dr Vivian Elizabeth 'lisa' Huddleston, MD is a medicare enrolled "Pediatrics" physician in Greenwood, Mississippi. Her current practice location is 1405 Strong Ave, Greenwood, Mississippi. You can reach out to her office (for appointments etc.) via phone at (662) 459-7030.

Dr Vivian Elizabeth 'lisa' Huddleston is licensed to practice in Mississippi (license number 18482) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1093784209.

Contact Information

Dr Vivian Elizabeth 'lisa' Huddleston, MD
1405 Strong Ave,
Greenwood, MS 38930-4035
(662) 459-7030
Not Available



Physician's Profile

Full NameDr Vivian Elizabeth 'lisa' Huddleston
GenderFemale
SpecialityPediatrics
Location1405 Strong Ave, Greenwood, Mississippi
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1093784209
  • Provider Enumeration Date: 03/17/2006
  • Last Update Date: 08/20/2019
  Medicare PECOS Information:
  • PECOS PAC ID: 7517152549
  • Enrollment ID: I20101116000384

Medical Identifiers

Medical identifiers for Dr Vivian Elizabeth 'lisa' Huddleston such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1093784209NPI-NPPES
06771370MedicaidMS

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208000000XPediatrics 18482 (Mississippi)Primary

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. Dr Vivian Elizabeth 'lisa' Huddleston allows following entities to bill medicare on her behalf.
Entity NameNorth Sunflower Medical Center
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1891705133
PECOS PAC ID: 7618932294
Enrollment ID: O20041123000318

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Entity NameState Of Mississippi - University Of Mississippi Medical Center
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1154317527
PECOS PAC ID: 1850293036
Enrollment ID: O20090414000575

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Entity NameGreenwood Leflore Hospital
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1669441994
PECOS PAC ID: 8224221619
Enrollment ID: O20101018001016

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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. Dr Vivian Elizabeth 'lisa' Huddleston 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 AddressPractice Location Address
Dr Vivian Elizabeth 'lisa' Huddleston, MD
Po Box 1410, Attn: Clinic Administration,
Greenwood, MS 38935-1410

Ph: (662) 459-7285
Dr Vivian Elizabeth 'lisa' Huddleston, MD
1405 Strong Ave,
Greenwood, MS 38930-4035

Ph: (662) 459-7030

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Pediatrics Doctors in Greenwood, MS

Dr. Claudine Stevens, MD
Pediatrics
Medicare: Medicare Enrolled
Practice Location: 1405 Strong Ave, Greenwood, MS 38930
Phone: 662-459-7030    
Mrs. Karlee Kelly, FNP
Pediatrics
Medicare: Medicare Enrolled
Practice Location: 1405 Strong Ave, Greenwood, MS 38930
Phone: 662-459-7030    Fax: 662-459-1104
Dr. Billy Boldon, DO
Pediatrics
Medicare: Medicare Enrolled
Practice Location: 1405 Strong Ave, Greenwood, MS 38930
Phone: 662-459-7030    Fax: 662-459-1104

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