North Mississippi Medical Center, Inc
Organization Active NPI Nurse Practitioner · Tupelo, MS
NPI 1790565521 · NPPES record last updated Sep 29, 2023
Key facts
- NPI
- 1790565521
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Nurse Practitioner 363L00000X
- Legal business name
- NORTH MISSISSIPPI MEDICAL CENTER, INC
- Practice address
- 2089 Southridge Dr
Tupelo, MS 38801-6478 - Phone
- (662) 407-0801
- Fax
- (662) 407-0807
- NPI assigned
- Sep 29, 2023
- Organization subpart
- No
Authorized official
- Name
- Bruce Toppin
- Title
- Corporate Secretary
- Phone
- (662) 377-4229
Practitioners 2
-
Katelyn Mitchell, MD
-
Israel Oloye, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pain Medicine Physician |
208VP0000X | |||
| Nurse Practitioner |
363L00000X | Yes |
Addresses
Primary practice location
2089 Southridge Dr
Tupelo, MS 38801-6478
Mailing address
808 Varsity Dr
Tupelo, MS 38801-4613
Phone (662) 377-2774
Other names
- North Mississippi Regional Pain Consultants-Southridge
Other providers in Tupelo, MS
- North Mississippi Medical Center Services LLC
- North Mississippi Medical Center Services LLC
- North Mississippi Medical Center Services LLC
- North Mississippi Medical Center Services, LLC
- North Mississippi Medical Center, Inc
- North Mississippi Medical Center, Inc
- North Mississippi Medical Center, Inc.
- North Mississippi Medical Center, Inc.
- North Mississippi Medical Center, Inc.
- North Mississippi Medical Center, Inc.
All providers in Tupelo, MS · Nurse Practitioner in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 29, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.