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North Mississippi Medical Center Inc

Organization Active NPI Psychologist · Tupelo, MS

NPI 1972608347 · NPPES record last updated Jan 22, 2025

Key facts

NPI
1972608347
Entity type
Organization (NPI type 2)
Primary specialty
Psychologist 103T00000X
Legal business name
NORTH MISSISSIPPI MEDICAL CENTER INC
Practice address
4579 S Eason Blvd Ste a
Tupelo, MS 38801-6539
Phone
(662) 377-3161
Fax
(662) 377-2993
NPI assigned
Sep 13, 2006
Organization subpart
No

Authorized official

Name
Bruce Toppin
Title
Corporate Secretary
Phone
(662) 377-4229

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 14

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

Practitioners 585

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

View all 585

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MS

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Baldwyn Nursing Facility
Baldwyn, MS · CCN 255161		 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control
Adp of the SNF		 Mar 16, 2009
Mar 16, 2009
Mar 16, 2009
Childrens Clinic - Tupelo
Tupelo, MS · CCN 258551		 Rural health clinic 5% Or Greater Indirect Ownership Interest (100%) Aug 24, 1992

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040413000541 MS Part B Supplier - Clinic/Group Practice 9931010600 Receives reassigned benefits from 570 practitioners
Practice locations: Tupelo, MS; West Point, MS; Starkville, MS; Corinth, MS; Oxford, MS

National Provider Directory

Tax ID family
Anant Shenoy MD (65 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP		 103T00000X Yes

Addresses

Primary practice location

4579 S Eason Blvd Ste a
Tupelo, MS 38801-6539

Mailing address

808 Varsity Dr
Tupelo, MS 38801-4613
Phone (662) 377-2386

Other identifiers

IdentifierTypeStateIssuer
CA5810OtherMSRAILROAD MEDICARE
009015893MedicaidMS
C02674OtherMSMEDICARE GROUP NUMBER
CJ3596OtherMSRAILROAD MEDICARE

Other names

  • Behavioral Health Center Doing business as

Other providers in Tupelo, MS

All providers in Tupelo, MS · Psychologist in Mississippi

Sources for this page

Verify at the official NPI Registry.