Greenwood Gastroenterology Center - Medicare Primary Care in Greenwood, MS

Greenwood Gastroenterology Center is a medicare enrolled primary clinic (Internal Medicine - Gastroenterology) in Greenwood, Mississippi. The current practice location for Greenwood Gastroenterology Center is 202 W Park Ave, Greenwood, Mississippi. For appointments, you can reach them via phone at (662) 455-8058. The mailing address for Greenwood Gastroenterology Center is Po Box 1410, Greenwood, Mississippi and phone number is (662) 455-8058.

Greenwood Gastroenterology Center is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1679802946. 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) 455-8058.

Contact Information

Greenwood Gastroenterology Center
202 W Park Ave
Greenwood
MS 38930
(662) 455-8058
Not Available

Primary Care Clinic Profile

Full NameGreenwood Gastroenterology Center
SpecialityInternal Medicine
Location202 W Park Ave, Greenwood, Mississippi
Authorized Official Name and PositionDawne Holmes (CFO)
Authorized Official Contact6624597119
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Greenwood Gastroenterology Center
Po Box 1410
Greenwood
MS 38935-1410

Ph: (662) 455-8058
Greenwood Gastroenterology Center
202 W Park Ave
Greenwood
MS 38930

Ph: (662) 455-8058

NPI Details:

NPI Number1679802946
Provider Enumeration Date12/16/2009
Last Update Date07/02/2018

Medicare PECOS Information:

Medicare PECOS PAC ID0941332910
Medicare Enrollment IDO20100712000112

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Medical Identifiers

Medical identifiers for Greenwood Gastroenterology Center such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1679802946NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207RG0100XInternal Medicine - Gastroenterology (* (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. Greenwood Gastroenterology Center acts as a billing entity for following providers:
Provider NameRichard A Goldberg
Provider TypePractitioner - Gastroenterology
Provider IdentifiersNPI Number: 1689831844
PECOS PAC ID: 2365688355
Enrollment ID: I20150713001539

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Provider NameKathryn Flanagan Evans
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1528434214
PECOS PAC ID: 4789946377
Enrollment ID: I20180319002513

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