Organization Active NPI

North Mississippi Family Medicine Group of Oxford PA

  • Family Medicine Physician
  • Oxford, MS
National Provider Identifier
1063649853
Registry record updated Jan 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
18421 Issued in MS
Legal business name
NORTH MISSISSIPPI FAMILY MEDICINE GROUP OF OXFORD PA
Practice address
1397 Belk Blvd
Oxford, MS 38655-5301
Phone
(662) 236-4675
Fax
(662) 281-0819
NPI assigned
Jun 18, 2009
Last updated
Jan 28, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2010

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

Authorized official

Name
Janice Lynn Levy
Title
Manager
Phone
(662) 236-4675

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 18421 MS Primary

Addresses

Primary practice location

1397 Belk Blvd
Oxford, MS 38655-5301

Mailing address

1397 Belk Blvd
Oxford, MS 38655-5301
Phone (662) 236-4675

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091027000170 MS Part B Supplier - Clinic/Group Practice 2567509482 Receives reassigned benefits from 7 practitioners
Practice locations: Oxford, MS

National Provider Directory

National Provider Directory

Locations

1397 Belk Blvd
Oxford, MS 38655
Phone (662) 236-4675

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1245283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264636800000",
    "number": "1063649853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1397 BELK BLVD",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386555301",
            "telephone_number": "662-236-4675",
            "fax_number": "662-281-0819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1397 BELK BLVD",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386555301",
            "telephone_number": "662-236-4675",
            "fax_number": "662-281-0819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH MISSISSIPPI FAMILY MEDICINE GROUP OF OXFORD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-18",
        "last_updated": "2010-01-28",
        "status": "A",
        "authorized_official_last_name": "LEVY",
        "authorized_official_first_name": "JANICE",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "662-236-4675"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "18421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxford, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.