NPIMap

Individual provider Active NPI

John Chalmers Neill Jr., M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Tupelo, MS
National Provider Identifier
1114330180
Registry record updated Jul 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
29081 Issued in MS
Practice address
830 S Gloster St FL 4
Tupelo, MS 38801-4934
Phone
(662) 377-7170
Fax
(662) 377-7180
NPI assigned
Jun 8, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 29081 MS Primary

Addresses

Primary practice location

830 S Gloster St FL 4
Tupelo, MS 38801-4934

Mailing address

830 S Gloster St FL 4
Tupelo, MS 38801-4934
Phone (662) 377-7170

Other practice location 1

2500 N State St
Jackson, MS 39216-4500
Phone (601) 984-5101

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210728001934 MS Practitioner - Vascular Surgery 4789900143 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Mississippi Medical Center, Inc. 361 clinicians

Practice addresses (Care Compare)

830 S Gloster St 4TH FL E Tower
Cardiothoracic and Vascular
Tupelo, MS 38801-4934
Phone (662) 377-7170

Hospital & facility affiliations

  • North Mississippi Medical Center Hospital, Tupelo, MS, CCN 250004

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)40
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
29081MSMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Mississippi Medical Center Inc Current Accepting new patients
North Mississippi Medical Center, Inc. CurrentSince Jul 14, 2021 Accepting new patients
North Mississippi Medical Center Current Accepting new patients
North Mississippi Medcial Center, Inc. CurrentSince Jul 14, 2021 Accepting new patients
Amory Surgery Clinic, PLLC Past Accepting new patients
North Mississippi Medical Center, Inc. Past Accepting new patients

Locations

3302 W Linden St
#A
Corinth, MS 38834
Phone (662) 331-1956

1207 Highway 182 W
Ste D
Starkville, MS 39759
Phone (662) 377-7170

830 S Gloster St
Tupelo, MS 38801
Phone (662) 377-3136

830 S Gloster St
Fl 4
Tupelo, MS 38801
Phone (662) 377-7100

Interoperability endpoints

  • Direct secure messaging: johnneill@nmhs.medalliesdirect.net

Organizations & group practices 13

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 13

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1402185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626912000000",
    "number": "1114330180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 S GLOSTER ST FL 4",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014934",
            "telephone_number": "662-377-7170",
            "fax_number": "662-377-7180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 S GLOSTER ST FL 4",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014934",
            "telephone_number": "662-377-7170",
            "fax_number": "662-377-7180"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 N State St",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "392164500",
            "country_code": "US",
            "telephone_number": "601-984-5101",
            "fax_number": "601-984-5110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEILL",
        "first_name": "JOHN",
        "middle_name": "CHALMERS",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-08",
        "last_updated": "2021-07-22",
        "certification_date": "2021-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "MS",
            "license": "29081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tupelo, MS

Sources for this page

Verify at the official NPI Registry.