Timothy M. South, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R701483 Issued in MS

Practice address

332 Highway 12 W
Kosciusko, MS 39090-3209

Phone

(662) 289-1800

Fax

(662) 289-2486

NPI assigned

Apr 7, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Nurse Practitioner

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Premier Medical Group of Mississippi LLCGroup PAC ID 8729973623, 31 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Medical Center Attala Hospital, Kosciusko, MS, CCN 251336

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tim.south.1@27768.direct.athenahealth.com

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.

• Premier Medical Group of Mississippi LLC

  • Clinic/Center
  • Kosciusko, MS
  • NPI 1790827038
  Medicare reassignment Care Compare group NPD
• Mississippi Band of Choctaw Indians

  • Ambulance
  • Choctaw, MS
  • NPI 1548358153
  NPD (past)
• Premier Medical Group of Mississippi LLC

  • Clinic/Center
  • Jackson, MS
  • NPI 1548219884
  NPD (past)

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

• BMC - Attala, LLC

  • Critical Access Hospital
  • Kosciusko, MS
  • NPI 1730566027
  Care Compare affiliation

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

{
    "created_epoch": "1144368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349049600000",
    "number": "1376506741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "332 HIGHWAY 12 W",
            "city": "KOSCIUSKO",
            "state": "MS",
            "postal_code": "390903209",
            "telephone_number": "662-289-1800",
            "fax_number": "662-289-2486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "332 HIGHWAY 12 W",
            "city": "KOSCIUSKO",
            "state": "MS",
            "postal_code": "390903209",
            "telephone_number": "662-289-1800",
            "fax_number": "662-289-2486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUTH",
        "first_name": "TIMOTHY",
        "middle_name": "M.",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-07",
        "last_updated": "2012-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R701483",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00114061",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecca Shields, PTA
• Makenzie Simmons, DPT
• Christi W Sims, P.T.
• Don E. Smith Sr., DDS
• Don Edwin Smith Jr., D.M.D.
• Southern Pharmaceutical Corporation
• Tanya L Steen, O.T.
• Sullivan'S Discount Drugs Inc.
• Sullivan'S Discount Drugs, Inc
• Susan Cappelli PT LLC

• Family Nurse Practitioner in Kosciusko, MS
• Providers in Kosciusko, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.