Individual provider Active NPI

Holly Corbin Poland

  • Nurse Practitioner
  • Tupelo, MS
National Provider Identifier
1346754793
Registry record updated May 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
902311 Issued in MS
Practice address
2089 Southridge Dr
Tupelo, MS 38801
Phone
(662) 407-0801
Fax
(662) 407-0801
NPI assigned
Nov 21, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 902311 MS Primary

Addresses

Primary practice location

2089 Southridge Dr
Tupelo, MS 38801

Mailing address

2089 Southridge Dr
Tupelo, MS 38801-6478
Phone (662) 407-0801

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180307000824 MS Practitioner - Nurse Practitioner 0446511455 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4381 S Eason Blvd
North Mississippi Regional Pain Con
Tupelo, MS 38801-6583
Phone (662) 377-5199

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
902311MSMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Mississippi Medical Center, Inc. CurrentSince Jul 31, 2023 Accepting new patients
North Mississippi Medcial Center, Inc. CurrentSince Jul 31, 2023 Accepting new patients
North Mississippi Medical Center Current Accepting new patients
Pain Management Center of North CurrentSince Feb 1, 2018 Accepting new patients
North Mississippi Medical Center Inc Current Accepting new patients
Amory Surgery Clinic, PLLC Past Accepting new patients

Locations

200 State Highway 30 W
New Albany, MS 38652
Phone (601) 534-7631

1205 Highway 182 W
#B
Starkville, MS 39759
Phone (662) 377-5199

1205 Highway 182 W
Starkville, MS 39759
Phone (662) 320-8545

4381 S Eason Blvd
Ste 201
Tupelo, MS 38801
Phone (662) 377-5005

4381 S Eason Blvd
Tupelo, MS 38801
Phone (662) 377-5199

2089 Southridge Dr
Tupelo, MS 38801
Phone (662) 407-0801

4381 S Eason Blvd
Ste 101
Tupelo, MS 38801
Phone (662) 377-4054

830 S Gloster St
Tupelo, MS 38801
Phone (662) 377-3136

Interoperability endpoints

  • Direct secure messaging: hollypoland@nmhs.medalliesdirect.net

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1511222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526515200000",
    "number": "1346754793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2089 SOUTHRIDGE DR",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388016478",
            "telephone_number": "662-407-0801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2089 SOUTHRIDGE DR",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "38801",
            "telephone_number": "662-407-0801",
            "fax_number": "662-407-0801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLAND",
        "first_name": "HOLLY",
        "middle_name": "CORBIN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-21",
        "last_updated": "2018-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "902311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tupelo, MS

Sources for this page

Verify at the official NPI Registry.