NPIMap

Organization Active NPI

Holly Springs Eyecare PLLC

Doing business as Magnolia Eye Group

  • Optometrist
  • Senatobia, MS
National Provider Identifier
1093420671
Registry record updated Jan 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
HOLLY SPRINGS EYECARE PLLC
Doing business as
Magnolia Eye Group
Practice address
106 E Main St
Senatobia, MS 38668-2138
Phone
(662) 562-5500
NPI assigned
Jan 18, 2023
Last updated
Jan 18, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
HOLLY SPRINGS EYECARE PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 18, 2023

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

Authorized official

Name
Stephen Patrick Edwards, ODNPI 1013015585
Title
Owner
Phone
(662) 473-2181

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

106 E Main St
Senatobia, MS 38668-2138

Mailing address

106 E Main St
Senatobia, MS 38668-2138
Phone (662) 562-5500

Other names 1

  • Magnolia Eye Group Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20070103000181 MS Part B Supplier - Clinic/Group Practice 2668472374 Receives reassigned benefits from 6 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Calhoun City, MS; Hernando, MS; Holly Springs, MS; Senatobia, MS; Water Valley, MS
O20250331001013 MS DME Supplier - Physician - Optometrist 2668472374 Practice locations: Senatobia, MS

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Holly Springs Eyecare PLLC5 organizations share this tax ID, including this one
Part of
Holly Springs Eyecare PLLC

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

106 E Main St
Senatobia, MS 38668
Phone (662) 562-5500

Practitioners & affiliated clinicians

Practitioners 2

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": "1674000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674000000000",
    "number": "1093420671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 E MAIN ST",
            "city": "SENATOBIA",
            "state": "MS",
            "postal_code": "386682138",
            "telephone_number": "662-562-5500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 E MAIN ST",
            "city": "SENATOBIA",
            "state": "MS",
            "postal_code": "386682138",
            "telephone_number": "662-562-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLLY SPRINGS EYECARE PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HOLLY SPRINGS EYECARE PLLC",
        "enumeration_date": "2023-01-18",
        "last_updated": "2023-01-18",
        "certification_date": "2023-01-18",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "PATRICK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "662-473-2181",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Magnolia Eye Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Senatobia, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2023; 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.