Organization Active NPI

Oxford Specialty Clinic

  • Family Nurse Practitioner
  • Oxford, MS
National Provider Identifier
1124632716
Registry record updated Oct 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
OXFORD SPECIALTY CLINIC
Practice address
1205 Office Park Dr
Oxford, MS 38655-3545
Phone
(662) 638-3412
NPI assigned
Sep 1, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2020

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

Authorized official

Name
Bridgett Green, CFNP
Title
Owner
Phone
(662) 638-3412

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

1205 Office Park Dr
Oxford, MS 38655-3545

Mailing address

PO Box 1454
Oxford, MS 38655-1454
Phone (662) 638-3412

Other identifiers 1

IdentifierTypeStateIssuer
07431342MedicaidMS

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL www.oxfordspecialtyclinic.com

National Provider Directory

National Provider Directory

Locations

120 Highway 6 W
Batesville, MS 38606
Phone (662) 360-1789

1205 Office Park Dr
Oxford, MS 38655
Phone (662) 638-3412

1205 Office Park Dr
Ste A
Oxford, MS 38655
Phone (662) 533-0220

Practitioners & affiliated clinicians

Practitioners 2

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": "1598918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603929600000",
    "number": "1124632716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1454",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386551454",
            "telephone_number": "662-638-3412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 OFFICE PARK DR",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386553545",
            "telephone_number": "662-638-3412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OXFORD SPECIALTY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-01",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-29",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "BRIDGETT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "662-638-3412",
        "authorized_official_credential": "CFNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07431342",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.oxfordspecialtyclinic.com",
            "affiliation": "N",
            "address_1": "1205 Office Park Dr",
            "city": "Oxford",
            "state": "MS",
            "country_code": "US",
            "postal_code": "386553545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Oct 29, 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.