NPIMap

Organization Active NPI

Panola Physician Group, LLC

  • Family Medicine Physician
  • Batesville, MS
National Provider Identifier
1528528874
Registry record updated Jul 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PANOLA PHYSICIAN GROUP, LLC
Practice address
255 Medical Center Drive
Batesville, MS 38606
Phone
(662) 563-5611
NPI assigned
Mar 22, 2019
Last updated
Jul 7, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2026

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

Authorized official

Name
Ashley Smith
Title
Associate Chief Executive Officer
Phone
(817) 253-7630

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

255 Medical Center Drive
Batesville, MS 38606

Mailing address

303 Medical Center Dr
Batesville, MS 38606-8608
Phone (662) 563-5611

Other practice location 1

303 Medical Center Dr
Batesville, MS 38606-8608
Phone (662) 563-5611

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address barbara.conway@panolamed.com
Direct Messaging Address barbara.conway@panolamed.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190515002618 MS Part B Supplier - Clinic/Group Practice 2668715624 Receives reassigned benefits from 35 practitioners
1 other NPI on this enrollment
Practice locations: Batesville, MS

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

223 E Main St
Senatobia, MS 38668
Phone (662) 213-5078

Practitioners & affiliated clinicians

Practitioners 51

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.

View all 51

NPI Registry JSON

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

{
    "created_epoch": "1553212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783382400000",
    "number": "1528528874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 MEDICAL CENTER DR",
            "city": "BATESVILLE",
            "state": "MS",
            "postal_code": "386068608",
            "telephone_number": "662-563-5611",
            "fax_number": "662-563-0155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 MEDICAL CENTER DRIVE",
            "city": "BATESVILLE",
            "state": "MS",
            "postal_code": "38606",
            "telephone_number": "662-563-5611"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "303 Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Batesville",
            "state": "MS",
            "postal_code": "386068608",
            "country_code": "US",
            "telephone_number": "662-563-5611",
            "fax_number": "662-563-0155",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PANOLA PHYSICIAN GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-22",
        "last_updated": "2026-07-07",
        "certification_date": "2026-07-07",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "ASSOCIATE CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "817-253-7630"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "barbara.conway@panolamed.com",
            "affiliation": "N",
            "address_1": "303 Medical Center Dr",
            "city": "Batesville",
            "state": "MS",
            "country_code": "US",
            "postal_code": "386068608",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "barbara.conway@panolamed.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "255 Medical Center Drive",
            "city": "Batesville",
            "state": "MS",
            "country_code": "US",
            "postal_code": "38606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Batesville, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.