NPIMap

Organization Active NPI

Medplus Starkville LLC

  • Family Medicine Physician
  • Starkville, MS
National Provider Identifier
1336749274
Registry record updated Oct 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MEDPLUS STARKVILLE LLC
Practice address
1207 Hwy 182 W
Starkville, MS 39759-9013
Phone
(662) 320-7800
Fax
(662) 269-6346
NPI assigned
Oct 29, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2025

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

Authorized official

Name
John Logan
Title
Authorized Official
Phone
(626) 320-7800

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Urgent Care Clinic/Center 261QU0200X
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

1207 Hwy 182 W
Starkville, MS 39759-9013

Mailing address

1207 Hwy 182 W
Starkville, MS 39759-9013
Phone (662) 320-7800

Other practice location 1

407 Interchange Drive
Fulton, MS 38843-6029
Phone (662) 841-0002

Other practice location 2

874 Barnes Crossing Road
Tupelo, MS 38804-0909
Phone (662) 841-0002

Other practice location 3

180 Park Plaza Drive
New Albany, MS 38652-3127
Phone (662) 222-2273

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20210317000911 MS Part B Supplier - Clinic/Group Practice 8527474576 Receives reassigned benefits from 7 practitioners
Practice locations: Fulton, MS; New Albany, MS; Starkville, MS; Tupelo, MS
O20250425001091 MS DME Supplier - Nurse PractitionerDME Supplier - Physician Assistant 8527474576 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
25D1068573Medplus Starkville LLC1207 Hwy 182 W, Starkville, MS 39759ComplianceAug 1, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

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": "1603929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761782400000",
    "number": "1336749274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1207 HWY 182 W",
            "city": "STARKVILLE",
            "state": "MS",
            "postal_code": "397599013",
            "telephone_number": "662-320-7800",
            "fax_number": "662-269-6346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207 HWY 182 W",
            "city": "STARKVILLE",
            "state": "MS",
            "postal_code": "397599013",
            "telephone_number": "662-320-7800",
            "fax_number": "662-269-6346"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "407 Interchange Drive",
            "address_purpose": "LOCATION",
            "city": "Fulton",
            "state": "MS",
            "postal_code": "388436029",
            "country_code": "US",
            "telephone_number": "662-841-0002",
            "fax_number": "662-269-6346",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "874 Barnes Crossing Road",
            "address_purpose": "LOCATION",
            "city": "Tupelo",
            "state": "MS",
            "postal_code": "388040909",
            "country_code": "US",
            "telephone_number": "662-841-0002",
            "fax_number": "662-269-6346",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "180 Park Plaza Drive",
            "address_purpose": "LOCATION",
            "city": "New Albany",
            "state": "MS",
            "postal_code": "386523127",
            "country_code": "US",
            "telephone_number": "662-222-2273",
            "fax_number": "662-269-6346",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MEDPLUS STARKVILLE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-29",
        "last_updated": "2025-10-30",
        "certification_date": "2025-10-30",
        "status": "A",
        "authorized_official_last_name": "LOGAN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "626-320-7800"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Oct 30, 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.