NPIMap

Organization Active NPI

TC Medical of New Albany PC

  • Family Medicine Physician
  • Ripley, MS
National Provider Identifier
1124644398
Registry record updated Jun 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
TC MEDICAL OF NEW ALBANY PC
Practice address
101 Cunningham Dr
Ripley, MS 38663-1302
Phone
(662) 837-3011
Fax
(662) 837-0230
NPI assigned
Jun 23, 2020
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Christopher Lane Park, DONPI 1710181078
Title
President
Phone
(662) 397-4597

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Practitioners 1

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

National Provider Directory

National Provider Directory

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

101 Cunningham Dr
Ripley, MS 38663-1302

Mailing address

542 Cedar Hill Dr
Pontotoc, MS 38863-7262
Phone (662) 397-4597

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 23, 2020.

{
    "created_epoch": "1592870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592870400000",
    "number": "1124644398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "542 CEDAR HILL DR",
            "city": "PONTOTOC",
            "state": "MS",
            "postal_code": "388637262",
            "telephone_number": "662-397-4597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 CUNNINGHAM DR",
            "city": "RIPLEY",
            "state": "MS",
            "postal_code": "386631302",
            "telephone_number": "662-837-3011",
            "fax_number": "662-837-0230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TC MEDICAL OF NEW ALBANY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-23",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "LANE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "662-397-4597",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ripley, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 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.