NPIMap

Organization Active NPI

Surgery Associates PA

  • Surgery Physician
  • Tupelo, MS
National Provider Identifier
1790760692
Registry record updated Mar 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
SURGERY ASSOCIATES PA
Practice address
440 Pegram Dr
Tupelo, MS 38801-6319
Phone
(662) 844-5344
Fax
(662) 844-5363
NPI assigned
Dec 13, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2026

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

Authorized official

Name
Samantha Lawman
Title
Clinic Administrator
Phone
(662) 844-5344

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208600000X Primary
Vascular Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2086S0129X

Addresses

Primary practice location

440 Pegram Dr
Tupelo, MS 38801-6319

Mailing address

440 Pegram Dr
Tupelo, MS 38801-6319
Phone (662) 844-5344

Other identifiers 1

IdentifierTypeStateIssuer
01588255MedicaidMS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040602000967 MS Part B Supplier - Clinic/Group Practice 5597747725 Receives reassigned benefits from 4 practitioners
Practice locations: Tupelo, MS

National Provider Directory

National Provider Directory

Locations

440 Pegram Dr
Tupelo, MS 38801
Phone (662) 844-5344

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1134432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773878400000",
    "number": "1790760692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 PEGRAM DR",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388016319",
            "telephone_number": "662-844-5344",
            "fax_number": "662-844-5363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 PEGRAM DR",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388016319",
            "telephone_number": "662-844-5344",
            "fax_number": "662-844-5363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGERY ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-13",
        "last_updated": "2026-03-19",
        "certification_date": "2026-03-19",
        "status": "A",
        "authorized_official_last_name": "LAWMAN",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_title_or_position": "CLINIC ADMINISTRATOR",
        "authorized_official_telephone_number": "662-844-5344"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01588255",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Mar 19, 2026; 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.