Mississippi Orthopaedics & Sports Medicine, PLLC

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

11962 Issued in MS

Legal business name

MISSISSIPPI ORTHOPAEDICS & SPORTS MEDICINE, PLLC

Practice address

391 Southcrest Cir
Suite 205
Southaven, MS 38671-6730

Phone

(662) 536-0900

NPI assigned

Feb 8, 2007

Last updated

Jul 3, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Rita B Christian, R.N.

Title

Practice Administrator

Phone

(662) 536-0900

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kenneth Bryan Gautier, M.D.

  • Pediatric Sports Medicine Physician
  • Senatobia, MS
  • NPI 1467551465
  NPD (past)
• Marcia W Kidder, P.T.

  • Physical Therapist
  • Southaven, MS
  • NPI 1306015185
  NPD (past)
• Hanna Michael Mitias, M.D.

  • Orthopaedic Surgery Physician
  • New Albany, MS
  • NPI 1265453401
  NPD (past)

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372809600000",
    "number": "1437299344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1107",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386710111",
            "telephone_number": "662-536-0900",
            "fax_number": "662-536-0914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "391 SOUTHCREST CIR",
            "address_2": "SUITE 205",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386716730",
            "telephone_number": "662-536-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSISSIPPI ORTHOPAEDICS & SPORTS MEDICINE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2013-07-03",
        "status": "A",
        "authorized_official_last_name": "CHRISTIAN",
        "authorized_official_first_name": "RITA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "662-536-0900",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MS",
            "license": "11962",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00574531",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00119607",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Muhammad M Mirza, MD
• Mary S Missak, M.D.
• Mississippi Behavior Services
• Mississippi CVS Pharmacy, L.L.C. (CVS Pharmacy #08994)
• Mississippi CVS Pharmacy, L.L.C. (CVS Pharmacy #08955)
• Mississippi State Department of Health
• Mississippi State Department of Health
• Mississippi Upper Cervical Clinic, Inc (Midsouth Integrative Chiropractic)
• Amy Mitchell
• Angela Gail Mitchell, FNP-C

• Orthopaedic Surgery Physician in Southaven, MS
• Providers in Southaven, MS by specialty
• Orthopaedic Surgery Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.