DELTA MEDICAL GROUP
NPI 1790701134
Emergency Medicine in Greenville, MS
NPI Status: Active since July 15, 2006
Contact Information
1693 FAIRGROUNDS RD
GREENVILLE, MS
ZIP 38703
Phone: (662) 725-2749
Fax: (662) 725-2741
- Organization
- Emergency Medicine
- Accepts Insurance
- CLIA Number: 25D0971010
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 05-19-2027
About DELTA MEDICAL GROUP
This page provides the complete NPI Profile along with additional information for Delta Medical Group, a provider established in Greenville, Mississippi operating as a Emergency Medicine. The healthcare provider is registered in the NPI registry with number 1790701134 assigned on July 2006. The practitioner's primary taxonomy code is 207P00000X. The provider is registered as an organization and their NPI record was last updated 4 years ago. Delta Medical Group operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Iris Stacker (Ceo)
- NPI
- 1790701134
- Provider Name
- DELTA MEDICAL GROUP
- Entity Type
- Organization
- Location Address
- 1693 FAIRGROUNDS RD GREENVILLE, MS 38703
- Location Phone
- (662) 725-2749
- Location Fax
- (662) 725-2741
- Mailing Address
- PO BOX 1734 GREENVILLE, MS 38702
- Mailing Phone
- (662) 725-2749
- Mailing Fax
- (662) 725-2741
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 07-15-2006
- Last Update Date
- 11-14-2022
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Emergency Medicine
- Taxonomy Code
- 207P00000X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | |
| 2 | 207RI0200X | Allopathic & Osteopathic Physicians | Internal Medicine | |
| 3 | 207RR0500X | Allopathic & Osteopathic Physicians | Internal Medicine | |
| 4 | 207T00000X | Allopathic & Osteopathic Physicians | Neurological Surgery | |
| 5 | 207UN0901X | Allopathic & Osteopathic Physicians | Nuclear Medicine | |
| 6 | 207V00000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | |
| 7 | 207X00000X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | |
| 8 | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | |
| 9 | 208200000X | Allopathic & Osteopathic Physicians | Plastic Surgery | |
| 10 | 2084N0400X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | |
| 11 | 2085R0202X | Allopathic & Osteopathic Physicians | Radiology | |
| 12 | 208600000X | Allopathic & Osteopathic Physicians | Surgery | |
| 13 | 208G00000X | Allopathic & Osteopathic Physicians | Thoracic Surgery (Cardiothoracic Vascular Surgery) | |
| 14 | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Choice Bronze HSA (QualChoice) - POS
- Complete Gold - PPO
- Complete Gold + Vision + Adult Dental - PPO
- Connected Silver - PPO
- Connected Silver (QualChoice) - POS
- Connected Silver (QualChoice) + Vision + Adult Dental - POS
- Connected Silver (QualChoiceLife) - PPO
- Connected Silver (QualChoiceLife) + Vision + Adult Dental - PPO
- Connected Silver + Vision + Adult Dental - PPO
- Elite Bronze - PPO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Elite Gold - EPO
- Elite Gold + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Focused Silver - EPO
- Focused Silver + Vision + Adult Dental - EPO
- Choice Bronze HSA - HMO
- Choice Bronze HSA + Vision + Adult Dental - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Everyday Gold - HMO
- Everyday Gold + Vision + Adult Dental - HMO
- Standard Expanded Bronze - HMO
- Standard Expanded Bronze + Vision + Adult Dental - HMO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Elite Gold - EPO
- Elite Gold + Vision + Adult Dental - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Elite Gold - EPO
- Elite Gold + Vision + Adult Dental - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Everyday Gold - EPO
- Everyday Gold + Vision + Adult Dental - EPO
- Molina Gold Standard - HMO
- Molina Silver Standard - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 156272002 | MEDICAID (05) | AR | |
| 09015100 | MEDICAID (05) | MS |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 25D0971010
- Facility Type
- Physician Office
- Certificate Effective Date
- May 20, 2025
- Certificate Expiration Date
- May 19, 2027
- Laboratory Director
- DR. ERIC REIMUND
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Delta Medical Group to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1790701134, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 56. The final step is to find the difference between that total and the next multiple of ten (60 - 56 = 4).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 56 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 2 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1790701134, enumerated as an "organization" on July 15, 2006.
The provider is located at 1693 FAIRGROUNDS RD GREENVILLE, MS 38703 and the phone number is (662) 725-2749.
Emergency Medicine with taxonomy code 207P00000X.
The provider might be accepting Accepts: Ambetter from Arkansas Health & Wellness, Ambetter. Please consult your insurance carrier or call the provider to verify.
