NPIMap

Organization Active NPI

North Mississippi Medcial Center, Inc.

Doing business as NMMC Neurodevelopmental Clinic

  • Pediatrics Physician
  • Tupelo, MS
National Provider Identifier
1235635566
Registry record updated Jan 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
NORTH MISSISSIPPI MEDCIAL CENTER, INC.
Doing business as
NMMC Neurodevelopmental Clinic
Practice address
199 Grandstand Place
Ste. 101
Tupelo, MS 38804
Phone
(626) 377-7337
Fax
(662) 377-1399
NPI assigned
Apr 4, 2018
Last updated
Jan 21, 2025By the provider in NPPES
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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

199 Grandstand Place
Ste. 101
Tupelo, MS 38804

Mailing address

808 Varsity Dr
Tupelo, MS 38801-4613
Phone (662) 377-2386

Other names 1

  • NMMC Neurodevelopmental Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040413000541 MS Part B Supplier - Clinic/Group Practice 9931010600 Receives reassigned benefits from 570 practitioners
This NPI is an additional NPI on the enrollment
Practice locations: Tupelo, MS; West Point, MS; Starkville, MS; Corinth, MS; Oxford, MS

National Provider Directory

National Provider Directory
Tax ID family
North Mississippi Med C65 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 22

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 22

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1522800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737417600000",
    "number": "1235635566",
    "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",
            "telephone_number": "662-377-2386",
            "fax_number": "662-377-2057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 GRANDSTAND PLACE",
            "address_2": "STE. 101",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "38804",
            "telephone_number": "626-377-7337",
            "fax_number": "662-377-1399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH MISSISSIPPI MEDCIAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-04",
        "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": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NMMC Neurodevelopmental Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tupelo, 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.