NPIMap

Organization Active NPI

North Mississippi Gilmore Clinics, LLC

  • Family Medicine Physician
  • Amory, MS
National Provider Identifier
1154885465
Registry record updated Jan 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
NORTH MISSISSIPPI GILMORE CLINICS, LLC
Practice address
404 Gilmore Dr
Amory, MS 38821-5414
Phone
(662) 256-3564
Fax
(662) 256-3996
NPI assigned
Jan 31, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2025

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

Authorized official

Name
Bruce Toppin
Title
Secretary
Phone
(662) 377-4229

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X

Addresses

Primary practice location

404 Gilmore Dr
Amory, MS 38821-5414

Mailing address

808 Varsity Dr
Tupelo, MS 38801-4613

Other identifiers 1

IdentifierTypeStateIssuer
004608882MedicaidMS

Other names 1

  • Amory Medical Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190510000063 MS Part B Supplier - Clinic/Group Practice 2961745195 Receives reassigned benefits from 23 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Hamilton, MS; Amory, MS

Other NPIs on the same Medicare enrollment 4

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
25D0316999North Ms Gilmore Clinic Dba Amory Medical Clinic404 Gilmore Drive, Amory, MS 38821ComplianceSep 13, 2026

National Provider Directory

National Provider Directory
Tax ID family
Amory Children'S Clinic6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

1107 Earl Frye Blvd
Ste 6
Amory, MS 38821
Phone (601) 256-9327

Practitioners & affiliated clinicians

Practitioners 8

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": "1548892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737417600000",
    "number": "1154885465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 VARSITY DR",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 GILMORE DR",
            "city": "AMORY",
            "state": "MS",
            "postal_code": "388215414",
            "telephone_number": "662-256-3564",
            "fax_number": "662-256-3996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH MISSISSIPPI GILMORE CLINICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-31",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A",
        "authorized_official_last_name": "TOPPIN",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "662-377-4229"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004608882",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Amory Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Amory, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.