NPIMap

Organization Active NPI

North Mississippi Medical Center Services LLC

Doing business as Ortho Trauma Services Clinic

  • Orthopaedic Surgery Physician
  • Tupelo, MS
National Provider Identifier
1790067932
Registry record updated Jan 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
NORTH MISSISSIPPI MEDICAL CENTER SERVICES LLC
Doing business as
Ortho Trauma Services Clinic
Practice address
4250 S Eason Blvd
Tupelo, MS 38801-6549
Phone
(662) 377-5265
Fax
(662) 377-5260
NPI assigned
Sep 14, 2011
Last updated
Jan 20, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
NORTH MISSISSIPPI MEDICAL CENTER SERVICES LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 20, 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
Orthopaedic Surgery Physician 207X00000X NU Primary

Addresses

Primary practice location

4250 S Eason Blvd
Tupelo, MS 38801-6549

Mailing address

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

Other names 1

  • Ortho Trauma Services Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111019000518 MS Part B Supplier - Clinic/Group Practice 6608048590 Receives reassigned benefits from 44 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Tupelo, MS

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
North Mississippi Medical Center Services LLC

Locations

4381 S Eason Blvd
Ste 204
Tupelo, MS 38801

Practitioners & affiliated clinicians

Practitioners 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1315958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737331200000",
    "number": "1790067932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "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"
        },
        {
            "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": {
        "organization_name": "NORTH MISSISSIPPI MEDICAL CENTER SERVICES LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTH MISSISSIPPI MEDICAL CENTER SERVICES LLC",
        "enumeration_date": "2011-09-14",
        "last_updated": "2025-01-20",
        "certification_date": "2025-01-20",
        "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": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ortho Trauma Services 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 20, 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.