The Woman's Clinic of Tupelo

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

THE WOMAN'S CLINIC OF TUPELO

Practice address

1512 Medical Park Cir
Tupelo, MS 38801-6560

Phone

(662) 844-0867

Fax

(662) 844-7086

NPI assigned

Dec 29, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Laura J Crecelius, M.D.NPI 1861470627

Title

OBGYN M.D.

Phone

(662) 844-0867

Specialties & licenses 1

Addresses

Other identifiers 3

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Laura Jane Crecelius, M.D.

  • Specialist
  • Corinth, MS
  • NPI 1861470627
  NPD (past) Authorized official
• Melissa L Barnett, CRNP

  • Obstetrics & Gynecology Nurse Practitioner
  • Tupelo, MS
  • NPI 1669450425
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1135814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1013994060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1512 MEDICAL PARK CIR",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388016560",
            "telephone_number": "662-844-0867",
            "fax_number": "662-844-7086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1512 MEDICAL PARK CIR",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388016560",
            "telephone_number": "662-844-0867",
            "fax_number": "662-844-7086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE WOMAN'S CLINIC OF TUPELO",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-29",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "CRECELIUS",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OBGYN M.D.",
        "authorized_official_telephone_number": "662-844-0867",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00117464",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00126770",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00019541",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Tupelo, MS
• Providers in Tupelo, MS by specialty
• Specialist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.