NPIMap

Organization Active NPI

Webster Health Services, Inc.

Doing business as Eupora Pediatric Clinic

  • Rural Health Clinic/Center
  • Eupora, MS
National Provider Identifier
1346584836
Registry record updated Jan 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
13-225 Issued in MS
Legal business name
WEBSTER HEALTH SERVICES, INC.
Doing business as
Eupora Pediatric Clinic
Practice address
15 Medical PLZ
Eupora, MS 39744-4019
Phone
(662) 258-4701
Fax
(662) 258-4215
NPI assigned
Nov 21, 2012
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
Mr. Bruce Toppin
Title
Corporate Secretary
Phone
(662) 377-4229

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 13-225 MS Primary

Addresses

Primary practice location

15 Medical PLZ
Eupora, MS 39744-4019

Mailing address

808 Varsity Dr
Tupelo, MS 38801-4613
Phone (662) 377-3204

Other identifiers 2

IdentifierTypeStateIssuer
25-8580OtherMSRURAL MEDICARE
009015461MedicaidMS

Other names 1

  • Eupora Pediatric Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130123000503 MS Part A Provider - Rural Health Clinic 6901892421 Practice locations: Eupora, MS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1346584836. Details of each certification follow.

Rural health clinic certification: CCN 258580

Legal name
WEBSTER HEALTH SERVICES INC
Doing business as
EUPORA PEDIATRIC CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Sep 25, 2013
Last certification
Sep 30, 2021
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Aug 24, 1992 in DE
Enrollment address
15 Medical Plaza
Eupora, MS 39744-4019
Related CCNs
250020

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Webster Health Services11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Ownership & related parties

All disclosed owners & managing parties 12

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Thomas Browder Individual Corporate DirectorBoard Member Feb 11, 2021
Belinda Stewart Individual Corporate DirectorBoard Member Oct 1, 2019
Stan Blaylock Individual Corporate DirectorBoard Member Oct 1, 2019
James Mason Individual Corporate DirectorBoard Member Oct 1, 2021
North Mississippi Health Services Inc Organization, Tupelo, MS Non-profit 5% Or Greater Indirect Ownership Interest Aug 24, 1992 100%
Bruce J Toppin Individual Corporate OfficerSecretary Jan 1, 2013
Sharon D Nobles Individual Corporate OfficerTreasurer Apr 4, 2017
Talmage Young Individual Corporate DirectorBoard Member Feb 11, 2021
Michael S Spees Individual Operational/Managerial ControlCeo Feb 1, 2014
Webster Health Services Inc Organization, Eupora, MS Non-profit 5% Or Greater Direct Ownership Interest Jan 1, 2013 100%
Harold H Whitaker Individual Corporate DirectorBoard Member Jan 1, 2013
Robin Mixon Individual W-2 Managing EmployeeAdministrator Oct 1, 2017

Owners & managing parties with NPI records 5

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 33

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1353456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737417600000",
    "number": "1346584836",
    "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": "662-377-3204",
            "fax_number": "662-377-2057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 MEDICAL PLZ",
            "city": "EUPORA",
            "state": "MS",
            "postal_code": "397444019",
            "telephone_number": "662-258-4701",
            "fax_number": "662-258-4215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEBSTER HEALTH SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-21",
        "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": "CORPORATE SECRETARY",
        "authorized_official_telephone_number": "662-377-4229",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "MS",
            "license": "13-225",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RURAL MEDICARE",
            "identifier": "25-8580",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009015461",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eupora Pediatric Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Eupora Pediatric Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eupora, MS

Sources for this page

Verify at the official NPI Registry.