Organization Active NPI

Mississippi Orthopaedics & Sports Medicine

  • Pediatric Orthopaedic Surgery Physician
  • New Albany, MS
National Provider Identifier
1104044494
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Orthopaedic Surgery PhysicianTaxonomy code 207XP3100X
License
13955 Issued in MS
Legal business name
MISSISSIPPI ORTHOPAEDICS & SPORTS MEDICINE
Practice address
220 Starlyn Ave
New Albany, MS 38652-2428
Phone
(662) 534-2227
NPI assigned
Apr 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Jana Lee Underwood
Title
Office Manager
Phone
(662) 890-3234

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207XP3100X 13955 MS Primary

Addresses

Primary practice location

220 Starlyn Ave
New Albany, MS 38652-2428

Mailing address

220 Starlyn Ave
New Albany, MS 38652-2428
Phone (662) 534-2227

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104044494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 STARLYN AVE",
            "city": "NEW ALBANY",
            "state": "MS",
            "postal_code": "386522428",
            "telephone_number": "662-534-2227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 STARLYN AVE",
            "city": "NEW ALBANY",
            "state": "MS",
            "postal_code": "386522428",
            "telephone_number": "662-534-2227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSISSIPPI ORTHOPAEDICS & SPORTS MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "UNDERWOOD",
        "authorized_official_first_name": "JANA",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "662-890-3234"
    },
    "taxonomies": [
        {
            "code": "207XP3100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
            "state": "MS",
            "license": "13955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Albany, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.