EXECUTIVE OUTCOMES PC
NPI 1821352808
Internal Medicine in Jackson, TN

Q: What is Executive Outcomes PC's NPI number?

The NPI number for Executive Outcomes PC is 1821352808. It was assigned to this organization in the NPPES registry on June 25, 2012.

Q: What is Executive Outcomes PC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Active since June 25, 2012

379 HOSPITAL BLVD, JACKSON, TN 38305(731) 661-6330 Get Directions Write a Review

NPPES record last updated: August 14, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Executive Outcomes Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EXECUTIVE OUTCOMES PC (NPI 1821352808) is a healthcare organization registered as an internal medicine in Jackson, Tennessee and active in the NPI registry since June 2012. The organization lists Monico P Banez, Owner, as its authorized official.

NPPES Registry Identity

NPI1821352808

Entity TypeOrganization

Primary Taxonomy207R00000X

Legal Business NameEXECUTIVE OUTCOMES PC

Location Address379 HOSPITAL BLVDJackson, TN 38305-2080

Mailing AddressPo Box 11355Jackson, TN 38308-0122 · (731) 234-5717 · Fax (423) 979-6333

Phone(731) 661-6330

Organization SubpartNo

Authorized OfficialMonico P BanezOwner · (731) 234-5717

Enumeration DateJune 25, 2012

Last NPPES UpdateAugust 14, 2025

NPPES CertifiedAugust 14, 2025

✔ NPI 1821352808 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

379 HOSPITAL BLVD, Jackson, TN 38305

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Executive Outcomes Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 2 clinicians reassign Medicare billing to Executive Outcomes PC, which bills Medicare for the services they deliver. Of these, 2 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (2)

Maria Antique, M.D.

Family Practice

NPI 1245278415

560 MCCELLAN ROAD
Jackson, TN 38305

(731) 234-5717

✔ PECOS✔ Accepts Medicare2.4 mi

Monico Banez, MD

Internal Medicine

NPI 1962479451

620 SKYLINE DR
Jackson, TN 38301

(731) 660-8759

✔ PECOS✔ Accepts Medicare3.5 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Executive Outcomes PC's NPI number?

The NPI number for Executive Outcomes PC is 1821352808. It was assigned to this organization in the NPPES registry on June 25, 2012.

Where is Executive Outcomes PC located?

Executive Outcomes PC is located at 379 Hospital Blvd, Jackson, TN 38305. The listed phone number is (731) 661-6330.

What is Executive Outcomes PC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Executive Outcomes PC enrolled in Medicare?

Yes. Executive Outcomes PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Executive Outcomes PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Executive Outcomes PC, in Family Practice and Internal Medicine. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Executive Outcomes PC accept?

Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Executive Outcomes PC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Executive Outcomes PC was last updated on August 14, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.