NPIMap

Organization Active NPI

North Mississippi Medical Center

Doing business as Behavioral Health Clinic

  • Psychiatry Physician
  • Tupelo, MS
National Provider Identifier
1730295585
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
NORTH MISSISSIPPI MEDICAL CENTER
Doing business as
Behavioral Health Clinic
Practice address
4579 S Eason Blvd Ste a
Tupelo, MS 38801-6539
Phone
(662) 377-7590
Fax
(662) 377-7595
NPI assigned
Aug 22, 2006
Last updated
Jan 22, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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

Authorized official

Name
Bruce Toppin
Title
Corporate Secretary
Phone
(662) 377-4229

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X Primary

Addresses

Primary practice location

4579 S Eason Blvd Ste a
Tupelo, MS 38801-6539

Mailing address

808 Varsity Dr
Tupelo, MS 38801-4613
Phone (662) 377-2386

Other identifiers 3

IdentifierTypeStateIssuer
009015827MedicaidMS
CA5810OtherMSRAILROAD MEDICARE
CJ3596OtherMSRAILROAD MEDICARE

Other names 1

  • Behavioral Health Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040413000541 MS Part B Supplier - Clinic/Group Practice 9931010600 Receives reassigned benefits from 570 practitioners
This NPI is an additional NPI on the enrollment
Practice locations: Tupelo, MS; West Point, MS; Starkville, MS; Corinth, MS; Oxford, MS

National Provider Directory

National Provider Directory
Tax ID family
Benjamin Groves MD65 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

1150 S Green St
Ste 2D
Tupelo, MS 38804
Phone (601) 815-3575

4577 S Eason Blvd
Ste E
Tupelo, MS 38801

4579 S Eason Blvd
Ste A
Tupelo, MS 38801
Phone (662) 377-6161

990 S Madison St
Ste 2A
Tupelo, MS 38801

Practitioners & affiliated clinicians

Practitioners 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737504000000",
    "number": "1730295585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 VARSITY DR",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014613",
            "telephone_number": "662-377-2386",
            "fax_number": "662-377-2057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4579 S EASON BLVD STE A",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388016539",
            "telephone_number": "662-377-7590",
            "fax_number": "662-377-7595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH MISSISSIPPI MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-22",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A",
        "authorized_official_last_name": "TOPPIN",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "CORPORATE SECRETARY",
        "authorized_official_telephone_number": "662-377-4229"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009015827",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CA5810",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CJ3596",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Behavioral Health Clinic",
            "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 Jan 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.