BAPTIST MEDICAL CENTER -LEAKE INC — NPI 1720336126 (Licensed & Credentialed Allopathic & Osteopathic Physicians

CMS-1500 Box 24J / 33a • NPI

1720336126

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

310 ELLIS ST, CARTHAGE, MS, 39051-3809

✓ 9-Digit EDI 837 ZIP+4 (39051-3809)

Practice Phone & Referral Fax

(601) 944-1717

Fax: (601) 944-9780

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1720336126 (BAPTIST MEDICAL CENTER -LEAKE INC) 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	`1720336126` (NPI-2 Organization / Facility)
Provider / Legal Name	BAPTIST MEDICAL CENTER -LEAKE INC
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	310 ELLIS ST, CARTHAGE, MS, 39051-3809
Practice Telephone / Fax	Tel: (601) 944-1717 \| Fax: (601) 944-9780
Administrative Mailing Address	350 N HUMPHREYS BLVD, MEMPHIS, TN, 38120-2177
Enumeration & Last Sync	Enumerated: 2012-08-16 \| CMS Record Updated: 2020-09-30
Authorized Official	GREGORY DUCKETT (SR VP/ CLO)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

310 ELLIS ST, CARTHAGE, MS, 39051-3809

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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 (BAPTIST MEDICAL CENTER -LEAKE INC)

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
`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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BAPTIST MEDICAL CENTER -LEAKE INC (NPI #1720336126)