Individual provider Active NPI

Jonathan Schneider, DO

  • Orthopaedic Trauma Physician
  • Tupelo, MS
National Provider Identifier
1730530064
Registry record updated Oct 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Trauma PhysicianTaxonomy code 207XX0801X
License
31487 Issued in MS
Practice address
4250 S Eason Blvd
Tupelo, MS 38801-6549
Phone
(662) 377-5265
Fax
(662) 377-5260
NPI assigned
Jun 28, 2016
Last updated
Oct 18, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Trauma Physician 207XX0801X 31487 MS Primary

Addresses

Primary practice location

4250 S Eason Blvd
Tupelo, MS 38801-6549

Mailing address

4311 E Lohman Ave
Las Cruces, NM 88011-8255
Phone (517) 917-5609

Other identifiers 1

IdentifierTypeStateIssuer
1730530064MedicaidMI

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
I20231026001556 MS Practitioner - Orthopedic Surgery 4486948387 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Edward Via Col of Osteo Medicine-Virginia Campus, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4250 S Eason Blvd
Ortho Trauma Services Clinic
Tupelo, MS 38801-6549
Phone (662) 377-5265

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Removal of tissue16

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Mississippi Medical Center Services LLC CurrentSince Aug 28, 2023 Accepting new patients
North Mississippi Medical Center Current Accepting new patients
North Mississippi Medical Center Services LLC CurrentSince Aug 28, 2023 Accepting new patients
North Mississippi Medical Center, Inc. Past Accepting new patients

Locations

4250 S Eason Blvd
Tupelo, MS 38801
Phone (662) 377-5265

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

Interoperability endpoints

  • Direct secure messaging: jonathanschneider@nmhs.medalliesdirect.net

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1467072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1730530064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4311 E LOHMAN AVE",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880118255",
            "telephone_number": "517-917-5609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4250 S EASON BLVD",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388016549",
            "telephone_number": "662-377-5265",
            "fax_number": "662-377-5260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHNEIDER",
        "first_name": "JONATHAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-28",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "MS",
            "license": "31487",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1730530064",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tupelo, MS

Sources for this page

Verify at the official NPI Registry.