Endoscopy Center of North Mississippi,LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

ENDOSCOPY CENTER OF NORTH MISSISSIPPI,LLC

Practice address

1206 Office Park Dr
Oxford, MS 38655-3597

Phone

(662) 236-1768

Fax

(662) 236-9898

NPI assigned

Aug 3, 2006

Organization subpart

No

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

Authorized official

Name

Kristina Materna

Title

Director, Credentialing

Phone

(901) 377-8219

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Listed as

Endoscopy Center of North MississippillcCCN 25C0001031

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Gastroenterology Center of the Midsouth PLLC

  • Gastroenterology Physician
  • Germantown, TN
  • NPI 1417932492

  Member Of

  NPD member

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael S Dragutsky, M.D.

  • Gastroenterology Physician
  • Germantown, TN
  • NPI 1851372213
  NPD
• Ernest Q Williams, MD

  • Gastroenterology Physician
  • Oxford, MS
  • NPI 1588623292
  NPD (past)

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770076800000",
    "number": "1356359632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 381468",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381831468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1206 OFFICE PARK DR",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386553597",
            "telephone_number": "662-236-1768",
            "fax_number": "662-236-9898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENDOSCOPY CENTER OF NORTH MISSISSIPPI,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-03",
        "last_updated": "2026-02-03",
        "certification_date": "2026-02-03",
        "status": "A",
        "authorized_official_last_name": "MATERNA",
        "authorized_official_first_name": "KRISTINA",
        "authorized_official_title_or_position": "DIRECTOR, CREDENTIALING",
        "authorized_official_telephone_number": "901-377-8219"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00770518",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Ellison, MSW
• Ahmed Elsayed, MD
• Mahmoud Elshawwaf
• Lakshmi Tejaswini Eluri
• Margaret Blake Embry, RN, MSN, CFNP
• Endurance Physical Therapy
• Envision Children'S Healthcare Services of North Mississippi, Inc.
• Cecilia Escario
• Grecia Marleny Estrada-Goin
• Charity Eubanks

• Ambulatory Surgical Clinic/Center in Oxford, MS
• Providers in Oxford, MS by specialty
• Ambulatory Surgical Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2026; 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.