NPIMap

Organization Active NPI

Oxford Outpatient Center, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Oxford, MS
National Provider Identifier
1649775123
Registry record updated Oct 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
OOC-AGENCY Issued in MS
Legal business name
OXFORD OUTPATIENT CENTER, LLC
Practice address
611 Commerce Pkwy
Oxford, MS 38655
Phone
(615) 727-8416
Fax
(615) 457-8094
NPI assigned
Mar 27, 2018
Last updated
Oct 11, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2024

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

Authorized official

Name
Ms. Keisha Wynn, MSN, RN
Title
Director of Outpatient Operations
Phone
(828) 215-1455

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X OOC-AGENCY MS Primary

Addresses

Primary practice location

611 Commerce Pkwy
Oxford, MS 38655

Mailing address

500 Wilson Pike Cir Ste 360
Brentwood, TN 37027-3266

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.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
25D2136882Oxford Outpatient Center, LLC611 Commerce Parkway, Oxford, MS 38655Certificate of waiverSep 17, 2027

National Provider Directory

National Provider Directory
Tax ID family
Oxford Outpatient Center LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

611 Commerce Pkwy
Oxford, MS 38655
Phone (615) 727-8416

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1522108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728604800000",
    "number": "1649775123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 WILSON PIKE CIR STE 360",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370273266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 COMMERCE PKWY",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "38655",
            "telephone_number": "615-727-8416",
            "fax_number": "615-457-8094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OXFORD OUTPATIENT CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-27",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-11",
        "status": "A",
        "authorized_official_last_name": "WYNN",
        "authorized_official_first_name": "KEISHA",
        "authorized_official_title_or_position": "DIRECTOR OF OUTPATIENT OPERATIONS",
        "authorized_official_telephone_number": "828-215-1455",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MSN, RN"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "MS",
            "license": "OOC-AGENCY",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Oct 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.