NPIMap

Organization Active NPI

Oxford Urology Associates, PLLC

  • Urology Physician
  • Oxford, MS
National Provider Identifier
1548327273
Registry record updated Dec 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
13909 Issued in MS
Legal business name
OXFORD UROLOGY ASSOCIATES, PLLC
Practice address
2168 S Lamar Blvd
Oxford, MS 38655-5224
Phone
(662) 234-1448
Fax
(662) 234-1103
NPI assigned
Jan 2, 2007
Last updated
Dec 12, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2018

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

Authorized official

Name
Ms. Amanda N Gardner
Title
Office Manager
Phone
(662) 234-1448

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 13909 MS Primary

Addresses

Primary practice location

2168 S Lamar Blvd
Oxford, MS 38655-5224

Mailing address

PO Box 1013
Oxford, MS 38655-1013
Phone (662) 234-1448

Other identifiers 1

IdentifierTypeStateIssuer
07675004MedicaidMS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050927000599 MS Part B Supplier - Clinic/Group Practice 1951336148 Receives reassigned benefits from 23 practitioners
Practice locations: Grenada, MS; Oxford, MS; New Albany, MS; Batesville, MS

National Provider Directory

National Provider Directory

Locations

5101 Sunwood Dr
Grenada, MS 38901
Phone (662) 234-1448

1201 Medical Park Dr
Oxford, MS 38655
Phone (622) 234-1448

2301 S Lamar Blvd
Ste 120
Oxford, MS 38655
Phone (662) 234-1443

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.

Practitioners & affiliated clinicians

Practitioners 23

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 23

NPI Registry JSON

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544572800000",
    "number": "1548327273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1013",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386551013",
            "telephone_number": "662-234-1448",
            "fax_number": "662-234-1103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2168 S LAMAR BLVD",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386555224",
            "telephone_number": "662-234-1448",
            "fax_number": "662-234-1103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OXFORD UROLOGY ASSOCIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2018-12-12",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "662-234-1448",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MS",
            "license": "13909",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07675004",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxford, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2018; 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.