The Columbus Orthopaedic Clinic, P.a.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

THE COLUMBUS ORTHOPAEDIC CLINIC, P.A.

Practice address

8613 Ms Highway 12
Ackerman, MS 39735-8917

Phone

(662) 328-1012

NPI assigned

Dec 20, 2023

Last updated

Dec 20, 2023By the provider in NPPES

Organization subpart

Yes

Parent organization

THE COLUMBUS ORTHOPAEDIC CLINIC, P.A.As reported in NPPES

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

Authorized official

Name

Tammy J Gavin

Title

Credentialing

Phone

(662) 370-1014

Specialties & licenses 1

Addresses

Other names 1

• The Columbus Orthopaedic Clinic, PA Former legal business name

Tax ID family

Charles Rhea MD5 organizations share this tax ID, including this one

Part of

Charles Rhea MD

Other organizations with this tax ID 4

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

• The Columbus Orthopaedic Clinic, P.a.

  • Durable Medical Equipment & Medical Supplies
  • Meridian, MS
  • NPI 1225849599
  NPD tax ID
• The Columbus Orthopaedic Clinic, P.a.

  • Durable Medical Equipment & Medical Supplies
  • Louisville, MS
  • NPI 1336917244
  NPD tax ID
• The Columbus Orthopaedic Clinic, P.a.

  • Durable Medical Equipment & Medical Supplies
  • Starkville, MS
  • NPI 1447028352
  NPD tax ID
• The Columbus Orthopaedic Clinic, P.a.

  • Durable Medical Equipment & Medical Supplies
  • Meridian, MS
  • NPI 1801607171
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• The Columbus Orthopaedic Clinic, P.a.

  • Orthopaedic Surgery Physician
  • Columbus, MS
  • NPI 1740287374
  NPPES parent name

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

{
    "created_epoch": "1703030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703030400000",
    "number": "1689442592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8613 MS HIGHWAY 12",
            "city": "ACKERMAN",
            "state": "MS",
            "postal_code": "397358917",
            "telephone_number": "662-328-1012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8613 MS HIGHWAY 12",
            "city": "ACKERMAN",
            "state": "MS",
            "postal_code": "397358917",
            "telephone_number": "662-328-1012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE COLUMBUS ORTHOPAEDIC CLINIC, P.A.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE COLUMBUS ORTHOPAEDIC CLINIC, P.A.",
        "enumeration_date": "2023-12-20",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A",
        "authorized_official_last_name": "GAVIN",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "662-370-1014"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Columbus Orthopaedic Clinic, PA",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Reshundra Shaffer, LMSW
• Jill Marie Shaw, FNP-BC
• Phillip Smith
• Terri Denise Swilley
• Lauren Rae Herring Thames, DMD
• Tru-Care Medical Ackerman
• Diane Watkins
• Virginia Wilbanks

• Durable Medical Equipment & Medical Supplies in Ackerman, MS
• Providers in Ackerman, MS by specialty
• Durable Medical Equipment & Medical Supplies in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.