NPIMap

Organization Active NPI

The Columbus Orthopaedic Clinic, P.a.

  • Orthopaedic Surgery Physician
  • Columbus, MS
National Provider Identifier
1740287374
Registry record updated Oct 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
THE COLUMBUS ORTHOPAEDIC CLINIC, P.A.
Practice address
670 Leigh Dr
Columbus, MS 39705-3014
Phone
(662) 328-1012
Fax
(662) 328-1507
NPI assigned
Jun 28, 2005
Last updated
Oct 24, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2022

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

Authorized official

Name
Miss Gina Walker
Title
Manager
Phone
(662) 328-1012

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X NU Primary

Addresses

Primary practice location

670 Leigh Dr
Columbus, MS 39705-3014

Mailing address

670 Leigh Dr
Columbus, MS 39705-3014
Phone (662) 328-1012

Other practice location 1

225 Tomlinson Dr
Starkville, MS 39759-7734
Phone (662) 498-1240

Other identifiers 6

IdentifierTypeStateIssuer
03500355MedicaidMS
00776741MedicaidMS
09011584MedicaidMS
09259057MedicaidMS
0114974MedicaidMS
05357253MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930077138 MS DME Supplier - Physician - Orthopedic/Orthopedic Surgery 5890751945 Practice locations: Columbus, MS
O20110331000380 MS Part B Supplier - Clinic/Group Practice 5890751945 Receives reassigned benefits from 53 practitioners
Practice locations: Philadelphia, MS; Starkville, MS; Mississippi State, MS; Meridian, MS; Macon, MS; Ackerman, MS; Columbus, MS; Louisville, MS

Other NPIs with the same Medicare PAC ID 2

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.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
25D2199806Columbus Orthopaedic Clinic PA670 Leigh Dr, Columbus, MS 39705Certificate of waiverNov 9, 2026

National Provider Directory

National Provider Directory

Locations

4 Professional Plz
Starkville, MS 39759
Phone (662) 323-3684

Ownership & related parties

Subparts reporting this organization as parent 6

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 53

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 53

NPI Registry JSON

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

{
    "created_epoch": "1119916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666569600000",
    "number": "1740287374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 LEIGH DR",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "397053014",
            "telephone_number": "662-328-1012",
            "fax_number": "662-328-1507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 LEIGH DR",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "397053014",
            "telephone_number": "662-328-1012",
            "fax_number": "662-328-1507"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "225 Tomlinson Dr",
            "address_purpose": "LOCATION",
            "city": "Starkville",
            "state": "MS",
            "postal_code": "397597734",
            "country_code": "US",
            "telephone_number": "662-498-1240",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "THE COLUMBUS ORTHOPAEDIC CLINIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-28",
        "last_updated": "2022-10-24",
        "certification_date": "2022-10-24",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "GINA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "662-328-1012",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03500355",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00776741",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09011584",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09259057",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0114974",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05357253",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2022; 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.