Bryan Christopher Fagan, M.D.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

20606 Issued in MS

Practice address

499 Gloster Creek VLG
Ste G1
Tupelo, MS 38801-4751

Phone

(662) 377-2663

Fax

(662) 377-6706

NPI assigned

May 24, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 3

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

Specialty

Orthopedic SurgeryAlso: Sports Medicine

Education

University of Arkansas College of Medicine, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Orthopaedic Institute of North Mississippi, LLCGroup PAC ID 7113914078, 10 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• North Mississippi Medical Ctr HHA Home health agency, Tupelo, MS, CCN 257002
• North Mississippi Medical Center-Gilmore Amory Hospital, Amory, MS, CCN 250025
• North Mississippi Medical Center Hospital, Tupelo, MS, CCN 250004
• Pontotoc Health Service Inc Cah Hospital, Pontotoc, MS, CCN 251308

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bryan_fagan_md@yourcarecommunity.org
• Direct secure messaging: bryanfagan@nmhs.medalliesdirect.net
• Direct secure messaging: bryanfagn@oa.exscribedirect.com

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.

• Orthopaedic Institute of North Mississippi, LLC

  • Orthopaedic Surgery Physician
  • Tupelo, MS
  • NPI 1790755320
  Medicare reassignment Care Compare group NPD
• North Mississippi Medical Center

  • General Acute Care Hospital
  • Tupelo, MS
  • NPI 1376969683
  NPD

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

• Monroe Health Services, Inc.

  • General Acute Care Hospital
  • Amory, MS
  • NPI 1164993457
  Care Compare affiliation
• North Mississippi Medical Center, Inc.

  • Home Health Agency
  • Tupelo, MS
  • NPI 1003871344
  Care Compare affiliation
• North Mississippi Medical Center, Inc.

  • General Acute Care Hospital
  • Tupelo, MS
  • NPI 1598875460
  Care Compare affiliation
• Pontotoc Health Services, Inc.

  • Critical Access Hospital
  • Pontotoc, MS
  • NPI 1821103516
  Care Compare affiliation

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674691200000",
    "number": "1669683405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "499 GLOSTER CREEK VLG",
            "address_2": "STE G1",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014751",
            "telephone_number": "662-377-2663",
            "fax_number": "662-377-6706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "499 GLOSTER CREEK VLG",
            "address_2": "STE G1",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014751",
            "telephone_number": "662-377-2663",
            "fax_number": "662-377-6706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAGAN",
        "first_name": "BRYAN",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-24",
        "last_updated": "2023-01-26",
        "certification_date": "2021-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MS",
            "license": "AU5009697-756",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "MS",
            "license": "20606",
            "primary": false
        },
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "MS",
            "license": "20606",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MS",
            "license": "20606",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "302I205607",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02629297",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00359815",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Orthopaedic Surgery Physician in Tupelo, MS
• Providers in Tupelo, MS by specialty
• Orthopaedic Surgery Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.