NPIMap

Organization Active NPI

Ortho Express Holding Company, LLC

  • Physician Assistant
  • Holly Springs, MS
National Provider Identifier
1629596804
Registry record updated May 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Legal business name
ORTHO EXPRESS HOLDING COMPANY, LLC
Practice address
273 Whaley Dr Ste B
Holly Springs, MS 38635-3243
Phone
(662) 333-8181
Fax
(662) 534-2330
NPI assigned
Sep 7, 2017
Organization subpart
Yes
Parent organization
ORTHOXPRESS HOLDINGS, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 20, 2026

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X Primary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

273 Whaley Dr Ste B
Holly Springs, MS 38635-3243

Mailing address

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

Other names 1

  • OrthoXpress of Holly Springs Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cassie.allred.1@11099.direct.athenahealth.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200929002373 MS DME Supplier - Physician Assistant 1951724392 Practice locations: Holly Springs, MS

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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
Ortho Express Holding Company, LLC273 Whaley Dr, Holly Springs, MS 38635-3243(662) 333-8181 Canes and/or Crutches|Orthoses: Off-The-Shelf|Surgical Dressings Accepts assignmentParticipating since Jun 1, 2020

National Provider Directory

National Provider Directory
Tax ID family
Ortho Express Holding Company LLC7 organizations share this tax ID, including this one
Part of
Ortho Express Holding Company LLC

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

173A Whaley Dr
Ste B
Holly Springs, MS 38635

173A Whaley Dr
Orthoxpress of Holly SPGS
Holly Springs, MS 38635

125 Goodman Rd W
Ste D
Southaven, MS 38671
Phone (662) 420-7350

101 Wilburn Way
Starkville, MS 39759
Phone (662) 323-9908

99 Market Center Dr
Collierville, TN 38017
Phone (901) 853-1174

1500 W Poplar Ave
Ste 301
Collierville, TN 38017
Phone (901) 759-5503

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1504742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779235200000",
    "number": "1629596804",
    "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",
            "fax_number": "662-534-2330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "273 WHALEY DR STE B",
            "city": "HOLLY SPRINGS",
            "state": "MS",
            "postal_code": "386353243",
            "telephone_number": "662-333-8181",
            "fax_number": "662-534-2330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHO EXPRESS HOLDING COMPANY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ORTHOXPRESS HOLDINGS, LLC",
        "enumeration_date": "2017-09-07",
        "last_updated": "2026-05-20",
        "certification_date": "2026-05-20",
        "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": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cassie.allred.1@11099.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "direct email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "173A Whaley Dr",
            "address_2": "Ste B",
            "city": "Holly Springs",
            "state": "MS",
            "country_code": "US",
            "postal_code": "38635",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "OrthoXpress of Holly Springs",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Holly Springs, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.