NPIMap

Individual provider Active NPI

Samuel Joseph Holdiness, M.D.

  • Internal Medicine Physician
  • Kosciusko, MS
National Provider Identifier
1942595202
Registry record updated Jun 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
33717 Issued in SC
Practice address
332 Highway 12 W
Kosciusko, MS 39090-3209
Phone
(662) 289-1800
Fax
(662) 289-2486
NPI assigned
Jun 15, 2011
Last updated
Jun 29, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 33717 SC Primary
Pediatrics Physician 208000000X 33717 SC

Addresses

Primary practice location

332 Highway 12 W
Kosciusko, MS 39090-3209

Mailing address

PO Box 23996
Jackson, MS 39225-3996
Phone (601) 206-6100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150821014005 MS Practitioner - Internal MedicinePractitioner - Pediatric Medicine 8729243084 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
University of Mississippi School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pontotoc Health Services, Inc.Group PAC ID 6002895356, 18 clinicians

Practice addresses (Care Compare)

176 S Main St
Pontotoc, MS 38863-3311
Phone (601) 489-5510

2161 S Lamar Blvd
Oxford, MS 38655-5223
Phone (662) 234-1791

345 Hwy 15 N
Pontotoc Medical
Pontotoc, MS 38863-3311
Phone (662) 489-7430

400 Doctors Dr
New Albany, MS 38652-3109
Phone (662) 534-5036

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Mississippi Medical Clinics Inc Internal Medicine CurrentSince Aug 11, 2025 Accepting new patients
North Mississippi Medical Center Current Accepting new patients
Pontotoc Health Services, Inc. CurrentSince Jun 30, 2025 Accepting new patients
North Mississippi Medical Clinics Inc CurrentSince Aug 11, 2025 Accepting new patients
Premier Medical Group of Mississippi LLC CurrentSince Jul 20, 2015 Accepting new patients
Pontotoc Health Services, Inc. Current Accepting new patients
Pontotoc Health Services, Inc. CurrentSince Jun 30, 2025 Accepting new patients
Premier Medical Group of Mississippi LLC Past Accepting new patients

Locations

202 Main St
Ecru, MS 38841
Phone (662) 489-4345

332 Highway 12 W
Kosciusko, MS 39090
Phone (601) 206-6100

530 Veterans Memorial Dr
Kosciusko, MS 39090
Phone (662) 289-9155

400 Doctors Dr
New Albany, MS 38652
Phone (662) 534-5036

2161 S Lamar Blvd
Oxford, MS 38655
Phone (662) 234-1791

345 Highway 15 N
Pontotoc, MS 38863
Phone (662) 489-7430

845 S Madison St
Tupelo, MS 38801
Phone (601) 790-5025

Interoperability endpoints

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

Organizations & group practices 8

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

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1308096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435536000000",
    "number": "1942595202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23996",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392253996",
            "telephone_number": "601-206-6100",
            "fax_number": "601-206-6052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "332 HIGHWAY 12 W",
            "city": "KOSCIUSKO",
            "state": "MS",
            "postal_code": "390903209",
            "telephone_number": "662-289-1800",
            "fax_number": "662-289-2486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLDINESS",
        "first_name": "SAMUEL",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-15",
        "last_updated": "2015-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "33717",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "33717",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kosciusko, MS

Sources for this page

Verify at the official NPI Registry.