North Mississippi Medical Center, Inc.
Organization Active NPI Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician · Corinth, MS
NPI 1366036253 · NPPES record last updated Jan 22, 2025
Key facts
- NPI
- 1366036253
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X
- Legal business name
- NORTH MISSISSIPPI MEDICAL CENTER, INC.
- Practice address
- 3302 W Linden St Ste a
Corinth, MS 38834-9119 - Phone
- (662) 331-1956
- Fax
- (662) 331-1962
- NPI assigned
- Feb 22, 2021
- Organization subpart
- No
Authorized official
- Name
- Bruce Toppin
- Title
- Corporate Secretary
- Phone
- (662) 377-4229
Corporate family (same tax ID) 24
Member organizations 2
Practitioners 7
-
Julia Lucius, RD
-
Van D Stone III, M.D.
-
William Louis Hills, M.D.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 25D2225776 | North Mississippi Medical Center Specialty Clinic | Certificate of waiver | May 23, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040413000541 | MS | Part B Supplier - Clinic/Group Practice | 9931010600 |
Receives reassigned benefits from 570 practitioners This NPI is an additional NPI on the enrollment Practice locations: Tupelo, MS; West Point, MS; Starkville, MS; Corinth, MS; Oxford, MS |
National Provider Directory
- Tax ID family
- Anant Shenoy MD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vascular Surgery Physician |
2086S0129X | |||
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
208G00000X | Yes | ||
| Family Nurse Practitioner |
363LF0000X |
Addresses
Primary practice location
3302 W Linden St Ste a
Corinth, MS 38834-9119
Mailing address
808 Varsity Dr
Tupelo, MS 38801-4613
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001901011 | Medicaid | MS |
Other names
- North Mississippi Medical Center Specialty Clinic
Other providers in Corinth, MS
- North Harper Minor Medical Clinic, LLC
- North Mississippi Clinics LLC
- North Mississippi Hematology & Oncology Assoc. LTD
- North Mississippi Medical Center, Inc
- North Mississippi Medical Center, Inc.
- North Mississippi Medical Center, Inc.
- North Mississippi Medical Center, Inc.
- North Mississippi Primary Health Care, Inc.
- North Point Cardiovascular and Thoracic Surgery Clinic
- Northeast Mississippi Pediatric Dental Associates, LLC.
All providers in Corinth, MS · Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 22, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.