Individual provider Active NPI

Clint Dylan Gunter

  • Family Nurse Practitioner
  • Tupelo, MS
National Provider Identifier
1619703485
Registry record updated Jun 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
906882 Issued in MS
Practice address
1211 S Gloster St Ste a
Tupelo, MS 38801-6548
Phone
(662) 767-4200
NPI assigned
Sep 10, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 906882 MS Primary
Primary Care Nurse Practitioner 363LP2300X 906882 MS

Addresses

Primary practice location

1211 S Gloster St Ste a
Tupelo, MS 38801-6548

Mailing address

171 Maffett Rd
Pontotoc, MS 38863-6935
Phone (662) 488-5330

Other practice location 1

171 Maffett Rd
Pontotoc, MS 38863-6935
Phone (662) 488-5330

Other practice location 2

100 Baptist Memorial Cir Ste 330
Oxford, MS 38655-4477
Phone (662) 767-4200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250114000819 MS Practitioner - Nurse Practitioner 3274061692 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Specialty Orthopedic Group of Mississippi PLLCGroup PAC ID 3577878883, 41 clinicians

Practice addresses (Care Compare)

1211 S Gloster St
Suite a
Tupelo, MS 38801-6548
Phone (662) 767-4200

Hospital & facility affiliations

  • Baptist Memorial Hospital North Ms Hospital, Oxford, MS, CCN 250034
  • North Mississippi Medical Center Hospital, Tupelo, MS, CCN 250004
  • Magnolia Regional Health Center Hospital, Corinth, MS, CCN 250009
  • Tishomingo Health Services Inc Hospital, Iuka, MS, CCN 250002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
906882MSMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Mississippi Medical Center Current Accepting new patients
Specialty Orthopedic Group of Mississippi PLLC Current Accepting new patients
Specialty Orthopedic Group of Ms PLLC CurrentSince Oct 3, 2024 Accepting new patients
Specialty Orthopedic Group of Mississippi PLLC CurrentSince Oct 3, 2024 Accepting new patients

Locations

723 Concordia Ave
Oxford, MS 38655

723 Concordia Ave
Ste 102
Oxford, MS 38655
Phone 66276742001057

100 Baptist Memorial Cir
Ste 330
Oxford, MS 38655
Phone 6627674200 ext. 1057

1211 S Gloster St
Ste A
Tupelo, MS 38801
Phone (662) 377-3380

Interoperability endpoints

  • Direct secure messaging: clintgunter@nmhs.medalliesdirect.net
  • Direct secure messaging: cgunter660231@direct.bmhcc.org

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1725926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749772800000",
    "number": "1619703485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "171 MAFFETT RD",
            "city": "PONTOTOC",
            "state": "MS",
            "postal_code": "388636935",
            "telephone_number": "662-488-5330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 S GLOSTER ST STE A",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388016548",
            "telephone_number": "662-767-4200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "171 Maffett Rd",
            "address_purpose": "LOCATION",
            "city": "Pontotoc",
            "state": "MS",
            "postal_code": "388636935",
            "country_code": "US",
            "telephone_number": "662-488-5330",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Baptist Memorial Cir Ste 330",
            "address_purpose": "LOCATION",
            "city": "Oxford",
            "state": "MS",
            "postal_code": "386554477",
            "country_code": "US",
            "telephone_number": "662-767-4200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUNTER",
        "first_name": "CLINT",
        "middle_name": "DYLAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-10",
        "last_updated": "2025-06-13",
        "certification_date": "2025-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "906882",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MS",
            "license": "906882",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tupelo, MS

Sources for this page

Verify at the official NPI Registry.