Ortho Express Holding Company, LLC
Organization Active NPI Nurse Practitioner · Atoka, TN
NPI 1508589367 · NPPES record last updated Feb 1, 2024
Key facts
- NPI
- 1508589367
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Nurse Practitioner 363L00000X
- Legal business name
- ORTHO EXPRESS HOLDING COMPANY, 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
- Organization subpart
- No
Authorized official
- Name
- Jennifer C Bullock
- Title
- President
- Phone
- (662) 534-2227
Subparts reporting this organization as parent 1
Corporate family (same tax ID) 6
Laboratory certificates & supplier records
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Orthoxpress of Atoka |
Canes and/or Crutches|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf|Surgical Dressings | Accepts assignment |
National Provider Directory
- Tax ID family
- Ortho Express Holding Company LLC
Interoperability endpoints
- timothy.w.pickens.2@11099.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant |
363A00000X | |||
| Nurse Practitioner |
363L00000X | Yes |
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
- OrthoXpress of Atoka, LLC
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | timothy.w.pickens.2@11099.direct.athenahealth.com | Direct |
Other providers in Atoka, TN
- MSK Group, PC
- MSK Group, PC
- MTN Orthoxpress Holdings, LLC
- Myeyedr Optometry of Tennessee, LLC
- Linda Denise Neeley
- Elizabeth Marie Otasowie
- Paula R Pairmore
- Randall T Paul
- Amanda Peery
- Danielle Spencer Petersen
All providers in Atoka, TN · Nurse Practitioner in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 1, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.