Organization Active NPI

Midsouth Plastic Surgery PLLC

Doing business as Midsouth Plastic Surgery

  • Plastic and Reconstructive Surgery Physician
  • Jackson, TN
National Provider Identifier
1376332387
Registry record updated May 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
Legal business name
MIDSOUTH PLASTIC SURGERY PLLC
Doing business as
Midsouth Plastic Surgery
Practice address
365 N Parkway Ste 200
Jackson, TN 38305-2876
Phone
(731) 426-3411
NPI assigned
May 5, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 26, 2025

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

Authorized official

Name
Dr. Jordi Puente Espel, MDNPI 1851657597
Title
Medical Doctor
Phone
(346) 717-7607

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0122X Primary

Addresses

Primary practice location

365 N Parkway Ste 200
Jackson, TN 38305-2876

Mailing address

106 N Spring Dr
Jackson, TN 38305-8116
Phone (346) 717-7607

Other practice location 1

5100 Sanderlin Ave Ste 1200
Memphis, TN 38117-4300
Phone (731) 426-3411

Other names 1

  • MIDSOUTH PLASTIC SURGERY Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250707002155 TN Part B Supplier - Clinic/Group Practice 0840704508 Receives reassigned benefits from 1 practitioner
Practice locations: Jackson, TN

National Provider Directory

National Provider Directory

Locations

365 N Parkway
Ste 200
Jackson, TN 38305
Phone (731) 426-3411

Practitioners & affiliated clinicians

Practitioners 1

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": "1746403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748217600000",
    "number": "1376332387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 N SPRING DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383058116",
            "telephone_number": "346-717-7607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 N PARKWAY STE 200",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052876",
            "telephone_number": "731-426-3411"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5100 Sanderlin Ave Ste 1200",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381174300",
            "country_code": "US",
            "telephone_number": "731-426-3411",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MIDSOUTH PLASTIC SURGERY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-05",
        "last_updated": "2025-05-26",
        "certification_date": "2025-05-26",
        "status": "A",
        "authorized_official_last_name": "PUENTE ESPEL",
        "authorized_official_first_name": "JORDI",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "346-717-7607",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MIDSOUTH PLASTIC SURGERY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MIDSOUTH PLASTIC SURGERY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jackson, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.