Individual provider Active NPI

Norman L Connell Jr., MD

  • Obstetrics & Gynecology Physician
  • Vicksburg, MS
National Provider Identifier
1659307296
Registry record updated Aug 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
16732 Issued in MS
Practice address
2100 Highway 61 N
Vicksburg, MS 39183-8211
Phone
(601) 883-5000
NPI assigned
Jun 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 16732 MS Primary

Addresses

Primary practice location

2100 Highway 61 N
Vicksburg, MS 39183-8211

Mailing address

2100 Highway 61 N
Vicksburg, MS 39183-8211
Phone (601) 883-5000

Other identifiers 3

IdentifierTypeStateIssuer
7023123OtherMSAETNA
0122875MedicaidMS
1483621MedicaidLA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040508000382 MS Practitioner - Obstetrics/Gynecology 6901895655 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Mississippi School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Obhg Mississippi PCGroup PAC ID 7416120407, 29 clinicians

Practice addresses (Care Compare)

1225 N State St
Jackson, MS 39202-2064
Phone (800) 967-2289

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
023337LAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Medical Center-Leake Inc CurrentSince Jun 21, 2019 Accepting new patients
Obstetrics Gynecology Associates PA Obstetrics & Gynecology CurrentSince Jun 27, 2024 Accepting new patients
North Mississippi Medical Center Current Accepting new patients
Vicksburg Clinic LLC Past Accepting new patients
Baptist Medical Center-Leake, Inc Past Accepting new patients
Mississippi Baptist Medical Center, Inc. Past Accepting new patients
Vicksburg Clinic LLC Obstetrics & Gynecology Past Accepting new patients
Vicksburg Clinic LLC Past Accepting new patients

Locations

1100 Highway 16 E
Carthage, MS 39051
Phone (601) 267-1100

1793 Cliff Gookin Blvd
Tupelo, MS 38801
Phone (662) 842-1161

830 S Gloster St
Tupelo, MS 38801
Phone (662) 377-3136

Interoperability endpoints

  • Direct secure messaging: nconnell145866@direct.bmhcc.org
  • Direct secure messaging: normanconnell@nmhs.medalliesdirect.net

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218412800000",
    "number": "1659307296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 HIGHWAY 61 N",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391838211",
            "telephone_number": "601-883-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 HIGHWAY 61 N",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391838211",
            "telephone_number": "601-883-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNELL",
        "first_name": "NORMAN",
        "middle_name": "L",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-24",
        "last_updated": "2008-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MS",
            "license": "16732",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7023123",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0122875",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1483621",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vicksburg, MS

Sources for this page

Verify at the official NPI Registry.