NPIMap

Organization Active NPI

Right Track Medical Group, Inc

  • Psychiatry Physician
  • Olive Branch, MS
National Provider Identifier
1972080257
Registry record updated Sep 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
21831 Issued in MS
Legal business name
RIGHT TRACK MEDICAL GROUP, INC
Practice address
9035 E Sandidge Rd Ste 201
Olive Branch, MS 38654-3563
Phone
(662) 234-7601
Fax
(662) 234-8531
NPI assigned
Jul 19, 2018
Reactivated
Mar 15, 2021
Last updated
Sep 3, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2025

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

Authorized official

Name
Kimberly Glaveskas
Title
Credentialing Manager
Phone
(214) 550-7536

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X 21831 MS Primary

Addresses

Primary practice location

9035 E Sandidge Rd Ste 201
Olive Branch, MS 38654-3563

Mailing address

PO Box 306600
Nashville, TN 37230-6600
Phone (662) 234-7601

Other practice location 1

4428 S Eason Blvd
Tupelo, MS 38801-6506
Phone (662) 234-7601

Other practice location 2

200 Highway 12 E
Starkville, MS 39759-3766
Phone (662) 234-7601

Other practice location 3

101 Aldersgate Cir
Hattiesburg, MS 39402-1301
Phone (662) 234-7601

Other practice location 4

117 Fountains Blvd Ste 1
Madison, MS 39110-6317
Phone (662) 234-7601

Other practice location 5

1203 Medical Park Dr
Oxford, MS 38655-5327
Phone (662) 234-7601

Other practice location 6

1641 Popps Ferry Rd Ste A3
Biloxi, MS 39532-2226
Phone (662) 234-7601

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, AL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20200728003297 MS Part B Supplier - Clinic/Group Practice 8729403415 Receives reassigned benefits from 63 practitioners
Practice locations: Tupelo, MS; Starkville, MS; Oxford, MS; Olive Branch, MS; Hattiesburg, MS; Biloxi, MS; Madison, MS
O20201002000118 AL Part B Supplier - Clinic/Group Practice 8729403415 Receives reassigned benefits from 3 practitioners
Practice locations: Tuscaloosa, AL

National Provider Directory

National Provider Directory

Locations

1633 Popps Ferry Rd
Ste 1633A
Biloxi, MS 39532

117 Fountains Blvd
Madison, MS 39110

9035 E Sandidge Rd
Ste 201
Olive Branch, MS 38654
Phone (662) 408-4631

Practitioners & affiliated clinicians

Practitioners 71

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 71

NPI Registry JSON

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

{
    "created_epoch": "1531958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756857600000",
    "number": "1972080257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 306600",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372306600",
            "telephone_number": "662-234-7601",
            "fax_number": "662-234-8531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9035 E SANDIDGE RD STE 201",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386543563",
            "telephone_number": "662-234-7601",
            "fax_number": "662-234-8531"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4428 S Eason Blvd",
            "address_purpose": "LOCATION",
            "city": "Tupelo",
            "state": "MS",
            "postal_code": "388016506",
            "country_code": "US",
            "telephone_number": "662-234-7601",
            "fax_number": "662-234-8531",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 Highway 12 E",
            "address_purpose": "LOCATION",
            "city": "Starkville",
            "state": "MS",
            "postal_code": "397593766",
            "country_code": "US",
            "telephone_number": "662-234-7601",
            "fax_number": "662-234-8531",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 Aldersgate Cir",
            "address_purpose": "LOCATION",
            "city": "Hattiesburg",
            "state": "MS",
            "postal_code": "394021301",
            "country_code": "US",
            "telephone_number": "662-234-7601",
            "fax_number": "662-234-8531",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "117 Fountains Blvd Ste 1",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "MS",
            "postal_code": "391106317",
            "country_code": "US",
            "telephone_number": "662-234-7601",
            "fax_number": "662-234-8531",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1203 Medical Park Dr",
            "address_purpose": "LOCATION",
            "city": "Oxford",
            "state": "MS",
            "postal_code": "386555327",
            "country_code": "US",
            "telephone_number": "662-234-7601",
            "fax_number": "662-234-8531",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1641 Popps Ferry Rd Ste A3",
            "address_purpose": "LOCATION",
            "city": "Biloxi",
            "state": "MS",
            "postal_code": "395322226",
            "country_code": "US",
            "telephone_number": "662-234-7601",
            "fax_number": "662-234-8531",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RIGHT TRACK MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-19",
        "last_updated": "2025-09-03",
        "certification_date": "2025-09-03",
        "deactivation_date": "2021-02-26",
        "reactivation_date": "2021-03-15",
        "status": "A",
        "authorized_official_last_name": "GLAVESKAS",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "214-550-7536"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MS",
            "license": "21831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olive Branch, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2025; 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.