NPIMap

Organization Active NPI

Magnolia Medical, LLC

  • Oxygen Equipment & Supplies (DME)
  • Natchez, MS
National Provider Identifier
1457786725
Registry record updated Jan 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X
Legal business name
MAGNOLIA MEDICAL, LLC
Practice address
304 Highland Blvd
Suite B
Natchez, MS 39120-4624
Phone
(601) 442-6493
Fax
(601) 445-0999
NPI assigned
Sep 5, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2015

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

Authorized official

Name
David Hyde
Title
Managing Partner
Phone
(225) 763-1314

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oxygen Equipment & Supplies (DME) 332BX2000X Primary
Prosthetic/Orthotic Supplier 335E00000X

Addresses

Primary practice location

304 Highland Blvd
Suite B
Natchez, MS 39120-4624

Mailing address

304 Highland Blvd
Suite B
Natchez, MS 39120-4624
Phone (601) 442-6493

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140109000963 MS DME Supplier - Medical Supply CompanyDME Supplier - Medical Supply Company With Orthotic-ProstheticDME Supplier - Oxygen & Equipment 6709091887 Practice locations: Natchez, MS

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Magnolia Medical LLC304 Highland Blvd, Natchez, MS 39120-4624(601) 442-6493 Commodes, Urinals, Bedpans|Contracture Treatment Devices: Dynamic Splint|Blood Glucose Monitors/Supplies (Non-Mail Order)|Blood Glucose Monitors/Supplies (Mail Order)|Hospital Beds (Electric)|Hospital Beds (Manual)|Neuromuscular Elect Stimulators (NMES)/Supplies|Osteogenesis Stimulators|Support Sur… Accepts assignmentParticipating since Jan 1, 2006

National Provider Directory

National Provider Directory
Tax ID family
Magnolia Medical LLC7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

304 Highland Blvd
Ste B
Natchez, MS 39120
Phone (601) 442-6493

Practitioners & affiliated clinicians

Practitioners 2

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": "1378339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421884800000",
    "number": "1457786725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 HIGHLAND BLVD",
            "address_2": "SUITE B",
            "city": "NATCHEZ",
            "state": "MS",
            "postal_code": "391204624",
            "telephone_number": "601-442-6493",
            "fax_number": "601-445-0999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 HIGHLAND BLVD",
            "address_2": "SUITE B",
            "city": "NATCHEZ",
            "state": "MS",
            "postal_code": "391204624",
            "telephone_number": "601-442-6493",
            "fax_number": "601-445-0999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA MEDICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-05",
        "last_updated": "2015-01-22",
        "status": "A",
        "authorized_official_last_name": "HYDE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "225-763-1314"
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Natchez, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.