Individual provider Active NPI

Eric Street, M.D.

  • Pediatrics Physician
  • Tupelo, MS
National Provider Identifier
1891906657
Registry record updated Aug 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
20590 Issued in MS
Practice address
1573 Medical Park Cir
Tupelo, MS 38801-6580
Phone
(662) 844-9885
Fax
(662) 842-1350
NPI assigned
May 24, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 18, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 20590 MS Primary

Addresses

Primary practice location

1573 Medical Park Cir
Tupelo, MS 38801-6580

Mailing address

1573 Medical Park Cir
Tupelo, MS 38801-6580
Phone (662) 844-9885

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210405001697 MS Practitioner - Pediatric Medicine 2365859584 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
North Mississippi Medcial Center, Inc. CurrentSince Mar 24, 2021 Accepting new patients
North Mississippi Medical Center, Inc. CurrentSince Mar 24, 2021 Accepting new patients
North Mississippi Medical Center Inc Current Accepting new patients
Amory Surgery Clinic, PLLC Past Accepting new patients
North Mississippi Medical Center, Inc. Past Accepting new patients

Locations

1573 Medical Park Cir
Tupelo, MS 38801
Phone (662) 419-2313

830 S Gloster St
Tupelo, MS 38801
Phone (662) 377-3136

Interoperability endpoints

  • Direct secure messaging: ericstreet@nmhs.medalliesdirect.net

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250553600000",
    "number": "1891906657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1573 MEDICAL PARK CIR",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388016580",
            "telephone_number": "662-844-9885",
            "fax_number": "662-842-1350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1573 MEDICAL PARK CIR",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388016580",
            "telephone_number": "662-844-9885",
            "fax_number": "662-842-1350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STREET",
        "first_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-24",
        "last_updated": "2009-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MS",
            "license": "20590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tupelo, MS

Sources for this page

Verify at the official NPI Registry.