Individual provider Active NPI

Justin C Duke, D.O.

  • Student in an Organized Health Care Education/Training Program
  • Tupelo, MS
National Provider Identifier
1457615601
Registry record updated Jul 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1665 S Green St
Tupelo, MS 38804-6556
Phone
(662) 377-2189
Fax
(662) 377-2263
NPI assigned
Jul 2, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MS Primary

Addresses

Primary practice location

1665 S Green St
Tupelo, MS 38804-6556

Mailing address

1665 S Green St
Tupelo, MS 38804-6556
Phone (662) 377-2189

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150708000867 MS Practitioner - Family Practice 7012229800 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3411 W Main St
Tupelo, MS 38801-9413
Phone (662) 844-9376

845 S Madison
Tupelo, MS 38801-4905
Phone (601) 790-5025

860 S Madison St
Tupelo, MS 38801-4905
Phone (662) 377-7150

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
North Mississippi Medical Clinics Inc CurrentSince Jun 1, 2015 Accepting new patients
North Mississippi Medical Clinics Inc Current Accepting new patients
North Mississippi Medical Clinics Inc CurrentSince Jun 1, 2015 Accepting new patients
North Mississippi Medical Center Current Accepting new patients

Locations

1913 Highway 45 N
Columbus, MS 39705
Phone (662) 328-1918

400 Doctors Dr
New Albany, MS 38652
Phone (662) 534-5036

903 Mississippi Dr
Tupelo, MS 38804
Phone (662) 377-4652

450 E President Ave
Tupelo, MS 38801
Phone (662) 377-3204

845 S Madison St
Tupelo, MS 38801
Phone (601) 790-5025

844 S Madison St
Tupelo, MS 38801
Phone (662) 377-5400

Interoperability endpoints

  • Direct secure messaging: justinduke@nmhs.medalliesdirect.net

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1341187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341187200000",
    "number": "1457615601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1665 S GREEN ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388046556",
            "telephone_number": "662-377-2189",
            "fax_number": "662-377-2263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1665 S GREEN ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388046556",
            "telephone_number": "662-377-2189",
            "fax_number": "662-377-2263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUKE",
        "first_name": "JUSTIN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-02",
        "last_updated": "2012-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tupelo, MS

Sources for this page

Verify at the official NPI Registry.