NPIMap

Organization Active NPI

Ortho Express Holding Company, LLC

Doing business as OrthoXpress of Tupelo

  • Nurse Practitioner
  • Tupelo, MS
National Provider Identifier
1720506264
Registry record updated Feb 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
ORTHO EXPRESS HOLDING COMPANY, LLC
Doing business as
OrthoXpress of Tupelo
Practice address
3952C N Gloster St
Tupelo, MS 38804-0913
Phone
(662) 350-0737
Fax
(662) 534-2330
NPI assigned
Sep 5, 2017
Last updated
Feb 17, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
ORTHOXPRESS HOLDINGS, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 17, 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) 534-2298

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X
Physician Assistant 363A00000X
Nurse Practitioner 363L00000X Primary

Addresses

Primary practice location

3952C N Gloster St
Tupelo, MS 38804-0913

Mailing address

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

Other names 1

  • OrthoXpress of Tupelo Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200915001761 MS DME Supplier - Nurse Practitioner 1951724392 Practice locations: Tupelo, 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, LLC3952 N Gloster St, Tupelo, MS 38804-0913(662) 350-0737 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
Orthoxpress Holdings LLC7 organizations share this tax ID, including this one
Part of
Orthoxpress Holdings LLC

Other organizations with this tax ID 6

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

NPI Registry JSON

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

{
    "created_epoch": "1504569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771286400000",
    "number": "1720506264",
    "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": "3952C N GLOSTER ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388040913",
            "telephone_number": "662-350-0737",
            "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": "2017-09-05",
        "last_updated": "2026-02-17",
        "certification_date": "2026-02-17",
        "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": "662-534-2298"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OrthoXpress of Tupelo",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tupelo, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 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.