NPIMap

Organization Active NPI

Ortho Express Holding Company, LLC

Doing business as OrthoXpress of Atoka, LLC

  • Nurse Practitioner
  • Atoka, TN
National Provider Identifier
1508589367
Registry record updated Feb 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
ORTHO EXPRESS HOLDING COMPANY, LLC
Doing business as
OrthoXpress of Atoka, LLC
Practice address
11645 Highway 51 S Ste 103
Atoka, TN 38004-7130
Phone
(901) 407-2221
Fax
(901) 407-2300
NPI assigned
Sep 26, 2022
Last updated
Feb 1, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2024

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

Authorized official

Name
Jennifer C Bullock
Title
President
Phone
(662) 534-2227

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Nurse Practitioner 363L00000X Primary

Addresses

Primary practice location

11645 Highway 51 S Ste 103
Atoka, TN 38004-7130

Mailing address

206 Oxford Rd
New Albany, MS 38652-3115
Phone (662) 534-2227

Other names 1

  • OrthoXpress of Atoka, LLC Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address timothy.w.pickens.2@11099.direct.athenahealth.com Direct

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
Orthoxpress of Atoka11645 Highway 51 S, Atoka, TN 38004-2001(901) 407-2221 Canes and/or Crutches|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf|Surgical Dressings Accepts assignmentParticipating since Jun 1, 2020

National Provider Directory

National Provider Directory
Tax ID family
Ortho Express Holding Co7 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.

Interoperability endpoints

  • Direct secure messaging: timothy.w.pickens.2@11099.direct.athenahealth.com

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1664150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706745600000",
    "number": "1508589367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 OXFORD RD",
            "city": "NEW ALBANY",
            "state": "MS",
            "postal_code": "386523115",
            "telephone_number": "662-534-2227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11645 HIGHWAY 51 S STE 103",
            "city": "ATOKA",
            "state": "TN",
            "postal_code": "380047130",
            "telephone_number": "901-407-2221",
            "fax_number": "901-407-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHO EXPRESS HOLDING COMPANY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-26",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A",
        "authorized_official_last_name": "BULLOCK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "662-534-2227"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "timothy.w.pickens.2@11099.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "Athena direct message addresss",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Athena",
            "address_1": "11645 Highway 51 S Ste 103",
            "city": "Atoka",
            "state": "TN",
            "country_code": "US",
            "postal_code": "380047130",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "OrthoXpress of Atoka, LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "OrthoXpress of Atoka, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Atoka, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.