NPIMap

Organization Active NPI

Ear Nose & Throat Consultants of North Mississippi PLLC

  • Otolaryngology Physician
  • Oxford, MS
National Provider Identifier
1265646368
Registry record updated Apr 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
EAR NOSE & THROAT CONSULTANTS OF NORTH MISSISSIPPI PLLC
Practice address
497 Azalea Dr Ste 101
Oxford, MS 38655-7907
Phone
(662) 234-1337
Fax
(662) 281-1490
NPI assigned
May 9, 2007
Last updated
Apr 18, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2011

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

Authorized official

Name
Ms. Amanda C Mooney
Title
Office Manager
Phone
(662) 234-1337

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X Primary

Addresses

Primary practice location

497 Azalea Dr Ste 101
Oxford, MS 38655-7907

Mailing address

497 Azalea Dr Ste 101
Oxford, MS 38655-7907
Phone (662) 234-1337

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080603000591 MS Part B Supplier - Clinic/Group Practice 8426136961 Receives reassigned benefits from 10 practitioners
Practice locations: Cleveland, MS; Oxford, MS; Grenada, MS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303084800000",
    "number": "1265646368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "497 AZALEA DR STE 101",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386557907",
            "telephone_number": "662-234-1337",
            "fax_number": "662-281-1490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "497 AZALEA DR STE 101",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386557907",
            "telephone_number": "662-234-1337",
            "fax_number": "662-281-1490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAR NOSE & THROAT CONSULTANTS OF NORTH MISSISSIPPI PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-09",
        "last_updated": "2011-04-18",
        "status": "A",
        "authorized_official_last_name": "MOONEY",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "662-234-1337",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 Apr 18, 2011; 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.