BATESVILLE HMA MEDICAL GROUP, LLC — NPI 1104117621 (Licensed & Credentialed Allopathic & Osteopathic Physicians

CMS-1500 Box 24J / 33a • NPI

1104117621

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

208M00000X (CMS C6)

Licensed & Credentialed Allopathic & Osteopathic Physicians — Hospitalist

Box 32 Service Location & ZIP+4

303 MEDICAL CENTER DR, BATESVILLE, MS, 38606-8608

✓ 9-Digit EDI 837 ZIP+4 (38606-8608)

Practice Phone & Referral Fax

(662) 712-2247

Fax: (662) 712-2180

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1104117621 (BATESVILLE HMA MEDICAL GROUP, LLC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1104117621` (NPI-2 Organization / Facility)
Provider / Legal Name	BATESVILLE HMA MEDICAL GROUP, LLC
Plain-English Specialty	Licensed & Credentialed Allopathic & Osteopathic Physicians — Hospitalist NUCC Code: `208M00000X` (Hospitalist)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	303 MEDICAL CENTER DR, BATESVILLE, MS, 38606-8608
Practice Telephone / Fax	Tel: (662) 712-2247 \| Fax: (662) 712-2180
Administrative Mailing Address	5811 PELICAN BAY BLVD, NAPLES, FL, 34108-2733
Enumeration & Last Sync	Enumerated: 2011-05-02 \| CMS Record Updated: 2012-11-26
Authorized Official	MICHAEL GINGRAS (Vice President)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

303 MEDICAL CENTER DR, BATESVILLE, MS, 38606-8608

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Plain-English Taxonomy & CMS Crosswalk (208M00000X)

What Does Taxonomy Code 208M00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 208M00000X translates to:
"Licensed & Credentialed Allopathic & Osteopathic Physicians — Hospitalist"

CMS-1500 Medicare Specialty Crosswalk: CMS Code C6 (Physician/Hospitalist)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Hospitalist for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (BATESVILLE HMA MEDICAL GROUP, LLC)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`207P00000X` — Emergency Medicine Plain English: Board-Certified Emergency Medicine Physician (ER / Trauma Doctor)	State: N/A \| License: `Verified` \| Primary: Secondary
`208600000X` — Surgery Plain English: Board-Certified Orthopedic Surgeon (Bone, Joint, Spine & Sports Injury Surgeon)	State: N/A \| License: `Verified` \| Primary: Secondary
`363L00000X` — Nurse Practitioner Plain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner	State: N/A \| License: `Verified` \| Primary: Secondary
`208M00000X` — Hospitalist Plain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — Hospitalist	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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BATESVILLE HMA MEDICAL GROUP, LLC (NPI #1104117621)