Oxford Outpatient Center, LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

OXFORD OUTPATIENT CENTER, LLC

Practice address

1150 Church Rd W
Southaven, MS 38671-7144

Phone

(662) 205-0455

NPI assigned

Jun 24, 2024

Organization subpart

No

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

Authorized official

Name

Ms. Keisha Wynn, BSN, RN

Title

Director of Outpatient Operations

Phone

(828) 215-1455

Specialties & licenses 1

Addresses

Other names 1

• Oxford Outpatient Center Southaven Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Oxford Outpatient Center LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Oxford Outpatient Center, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Oxford, MS
  • NPI 1649775123
  NPD tax ID

Locations

Practitioners 1

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

• Michael Patrick McCallum, MS, PCMHT

  • Addiction (Substance Use Disorder) Counselor
  • Southaven, MS
  • NPI 1023557865
  NPD

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

{
    "created_epoch": "1719187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719187200000",
    "number": "1881438992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 CHURCH RD W",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386717144",
            "telephone_number": "662-205-0455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 CHURCH RD W",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386717144",
            "telephone_number": "662-205-0455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OXFORD OUTPATIENT CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-24",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-23",
        "status": "A",
        "authorized_official_last_name": "WYNN",
        "authorized_official_first_name": "KEISHA",
        "authorized_official_title_or_position": "DIRECTOR OF OUTPATIENT OPERATIONS",
        "authorized_official_telephone_number": "828-215-1455",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "BSN, RN"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oxford Outpatient Center Southaven",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Debra Ann Oswalt, CRNA
• Otolaryngology Associates of the Midsouth
• Debra Ann Ottens, PT
• Hannah Elizabeth Owens
• Steven Keith Owens, CRNA
• John C Page, D.D.S., M.S.
• Pain Clinic Associates PLLC
• Pain Treatment Centers of America, PLLC
• Sabrina Palacio, PT, DPT
• Pandya-Lipman Eye Specialist, PLLC

• Substance Abuse Rehabilitation Facility in Southaven, MS
• Providers in Southaven, MS by specialty
• Substance Abuse Rehabilitation Facility in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.