NPIMap

Samuel Joseph Holdiness, M.D.

Individual provider Active NPI Internal Medicine Physician · Kosciusko, MS

NPI 1942595202 · NPPES record last updated Jun 29, 2015

Key facts

NPI
1942595202
Entity type
Individual (NPI type 1)
Primary specialty
Internal Medicine Physician 207R00000X
License
33717 (SC)
Practice address
332 Highway 12 W
Kosciusko, MS 39090-3209
Phone
(662) 289-1800
Fax
(662) 289-2486
NPI assigned
Jun 15, 2011
Sex
Male
Sole proprietor
No

Organizations & group practices 10

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.

Hospital & facility affiliations 3

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

Medicare Care Compare profile

Specialty
Internal Medicine
Also: 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. (18 clinicians)
North Mississippi Medical Clinics Inc (120 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

  • Pontotoc Health Service Inc Cah Hospital · Pontotoc, MS · CCN 251308
  • North Mississippi Medical Center Hospital · Tupelo, MS · CCN 250004
  • Baptist Memorial Hospital North Ms Hospital · Oxford, MS · CCN 250034

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

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

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
33717SCMDInternal Medicine Physician

Practice roles

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

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

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

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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 33717 SC Yes
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

Other providers in Kosciusko, MS

All providers in Kosciusko, MS · Internal Medicine Physician in Mississippi

Sources for this page

Verify at the official NPI Registry.