North Mississippi Medical Center Services LLC
Organization Active NPI Orthopaedic Surgery Physician · Tupelo, MS
NPI 1982949046 · NPPES record last updated Jan 20, 2025
Key facts
- NPI
- 1982949046
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Orthopaedic Surgery Physician 207X00000X
- Legal business name
- NORTH MISSISSIPPI MEDICAL CENTER SERVICES LLC
- Practice address
- 808 Garfield St
Tupelo, MS 38801-5749 - Phone
- (662) 377-5265
- Fax
- (662) 377-5260
- NPI assigned
- Nov 30, 2012
- Organization subpart
- Yes
- Parent organization (as reported)
- NORTH MISSISSIPPI MEDICAL CENTER SERVICES LLC
Authorized official
- Name
- Bruce Toppin
- Title
- Corporate Secretary
- Phone
- (662) 377-4229
Other NPIs on the same Medicare enrollment 3
Member of 1
Practitioners 43
-
Aynsley Elizabeth Bailey, PA-C
-
Amy M. Ballard, P.A.
-
Richard Dane Ballard, M.D.
-
Benjamin David Blossom, M.D.
-
Jonathan Ashley Blossom, M.D.
-
Henry B Boler, MD
-
Michael Ted Boler Jr., D.O.
-
Will Cauthen, M.D.
-
Jessica Elizabeth Davis, PA-C
-
Ashley Nicole Dodson, PA-C
-
Douglas L Hill, MD
-
Nelson K Little, MD
-
Logan Scott Lyle, FNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20111019000518 | MS | Part B Supplier - Clinic/Group Practice | 6608048590 |
Receives reassigned benefits from 44 practitioners 3 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Tupelo, MS |
National Provider Directory
- Part of
- North Mississippi Medical Center Services LLC
Locations
808 Garfield St
Tupelo, MS 38801
Phone (601) 840-5747
607 Garfield St
Tupelo, MS 38801
Phone (662) 377-6290
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician |
207X00000X | Yes |
Addresses
Primary practice location
808 Garfield St
Tupelo, MS 38801-5749
Mailing address
808 Garfield St
Tupelo, MS 38801-5749
Phone (662) 377-5265
Other names
- Ortho Trauma Services Clinic 2
Other providers in Tupelo, MS
- North Mississippi Medical Center Inc.
- North Mississippi Medical Center Inc.
- North Mississippi Medical Center Services LLC
- North Mississippi Medical Center Services LLC
- North Mississippi Medical Center Services LLC
- North Mississippi Medical Center Services, LLC
- North Mississippi Medical Center, Inc
- North Mississippi Medical Center, Inc
- North Mississippi Medical Center, Inc
- North Mississippi Medical Center, Inc.
All providers in Tupelo, MS · Orthopaedic Surgery Physician in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 20, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.