NPIMap

Organization Active NPI

Starkville Clinic for Women, PA

  • Obstetrics & Gynecology Physician
  • Starkville, MS
National Provider Identifier
1265513071
Registry record updated Dec 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
STARKVILLE CLINIC FOR WOMEN, PA
Practice address
100 Medical Park Drive
Starkville, MS 39759
Phone
(662) 324-4201
Fax
(662) 765-0008
NPI assigned
Oct 18, 2006
Last updated
Dec 28, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2016

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

Authorized official

Name
Tommy Cobb, MDNPI 1346321189
Title
President
Phone
(662) 324-4201

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X NU Primary

Addresses

Primary practice location

100 Medical Park Drive
Starkville, MS 39759

Mailing address

100 Medical Park Drive
Starkville, MS 39759
Phone (662) 324-4201

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080808000162 MS Part B Supplier - Clinic/Group Practice 2264506286 Receives reassigned benefits from 14 practitioners
Practice locations: Starkville, MS

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
25D0706973Starkville Clinic for Women PA100 Medical Park Drive, Starkville, MS 39759ComplianceMay 31, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 14

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 14

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482883200000",
    "number": "1265513071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MEDICAL PARK DRIVE",
            "city": "STARKVILLE",
            "state": "MS",
            "postal_code": "39759",
            "telephone_number": "662-324-4201",
            "fax_number": "662-765-0008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MEDICAL PARK DRIVE",
            "city": "STARKVILLE",
            "state": "MS",
            "postal_code": "39759",
            "telephone_number": "662-324-4201",
            "fax_number": "662-765-0008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STARKVILLE CLINIC FOR WOMEN, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2016-12-28",
        "status": "A",
        "authorized_official_last_name": "COBB",
        "authorized_official_first_name": "TOMMY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "662-324-4201",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Starkville, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2016; 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.