NPIMap

Organization Active NPI

Specialty Orthopedic Group of Mississippi PLLC

  • Orthopaedic Surgery Physician
  • Senatobia, MS
National Provider Identifier
1801491352
Registry record updated Dec 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
SPECIALTY ORTHOPEDIC GROUP OF MISSISSIPPI PLLC
Practice address
2778 Highway 51 S
Senatobia, MS 38668-9403
Phone
(662) 767-4200
Fax
(662) 767-4204
NPI assigned
Dec 2, 2020
Last updated
Dec 2, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
SPECIALTY ORTHOPEDIC GROUP OF MISSISSIPPI PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 2, 2020

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

Authorized official

Name
Jenny Mills
Title
Credentialing Specialist
Phone
(662) 767-4200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X Primary

Addresses

Primary practice location

2778 Highway 51 S
Senatobia, MS 38668-9403

Mailing address

1211 S Gloster St Ste a
Tupelo, MS 38801-6548
Phone (662) 767-4200

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20150817000322 MS Part B Supplier - Clinic/Group Practice 3577878883 Receives reassigned benefits from 49 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Batesville, MS; New Albany, MS; Oxford, MS; Senatobia, MS; Starkville, MS; Tupelo, MS
O20260304000171 MS DME Supplier - Physician - Orthopedic/Orthopedic Surgery 3577878883 Practice locations: Senatobia, MS

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 5

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

National Provider Directory

National Provider Directory
Part of
Specialty Orthopedic Group of Mississippi PLLC

Locations

723 Concordia Ave
Oxford, MS 38655

723 Concordia Ave
Ste 102
Oxford, MS 38655
Phone 66276742001057

118 Highway 12 W
Ste C
Starkville, MS 39759
Phone 66276742001057

1211 S Gloster St
Ste A
Tupelo, MS 38801
Phone (662) 377-3380

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 45

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 45

NPI Registry JSON

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

{
    "created_epoch": "1606867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606867200000",
    "number": "1801491352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 S GLOSTER ST STE A",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388016548",
            "telephone_number": "662-767-4200",
            "fax_number": "662-767-4204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2778 HIGHWAY 51 S",
            "city": "SENATOBIA",
            "state": "MS",
            "postal_code": "386689403",
            "telephone_number": "662-767-4200",
            "fax_number": "662-767-4204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALTY ORTHOPEDIC GROUP OF MISSISSIPPI PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPECIALTY ORTHOPEDIC GROUP OF MISSISSIPPI PLLC",
        "enumeration_date": "2020-12-02",
        "last_updated": "2020-12-02",
        "certification_date": "2020-12-02",
        "status": "A",
        "authorized_official_last_name": "MILLS",
        "authorized_official_first_name": "JENNY",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "662-767-4200"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Senatobia, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2020; 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.