NORTH MISSISSIPPI MEDICAL CENTER, INC. (NPI# 1013385715) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013385715 |
| Entity Type | Organization |
| Organization Name | NORTH MISSISSIPPI MEDICAL CENTER, INC. |
| Other Organization Name | NORTH MISSISSIPPI NEUROSURGICAL SERVICES |
| Practice Address |
4381 S Eason Blvd Suite 302 Tupelo MS 38801-6583 |
| Mailing Address |
450 E President Ave Tupelo MS 38801-5599 |
| Practice Telephone | 6623775700 |
| Practice Fax Number | 6623775720 |
| Mailing Telephone | 6623774685 |
| Mailing Fax Number | 6623772755 |
| Enumeration Date | 2015-09-11 |
| Last Update Date | 2015-09-11 |
| Authorized Official Name | JOSEPH REPPERT (VICE PRESIDENT) |
| Authorized Official Telephone | 6623773978 |
| Is Organization Subpart | Y |
| Parent Organization Name | NORTH MISSISSIPPI HEALTH SERVICES, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207T00000X | Neurological Surgery | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| North Mississippi Neurosurgical Services | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285234104 | North Mississippi Medical Center, Inc. | Surgery | 499 Gloster Creek Vlg Ste S-3, Tupelo, MS 38801-4600 | 2020-10-29 |
| 1871101378 | North Mississippi Medical Center, Inc. | Psychiatry & Neurology | 408 Council Cir Ste B, Tupelo, MS 38801-4949 | 2020-07-21 |
| 1740835305 | North Mississippi Medical Center, Inc. | Internal Medicine | 408 Council Cir Ste A, Tupelo, MS 38801-4949 | 2019-08-09 |
| 1689028391 | North Mississippi Medical Center, Inc. | Psychologist | 2704 W Oxford Loop # 110, Oxford, MS 38655-5714 | 2016-04-19 |
| 1164539193 | North Mississippi Medical Center, Inc. | Skilled Nursing Facility | 739 Fourth Street, Baldwyn, MS 38824 | 2006-08-24 |
| 1942317326 | North Mississippi Medical Center, Inc. | Durable Medical Equipment & Medical Supplies | 990 S Madison St, Suite 2, Tupelo, MS 38801-6308 | 2006-08-23 |
| 1982669156 | North Mississippi Medical Center, Inc. | Hospice Care, Community Based | 422-b East President Ave, Tupelo, MS 38801-5500 | 2006-04-19 |
| 1003871344 | North Mississippi Medical Center, Inc. | Home Health | 424 East President Street, Tupelo, MS 38801-5500 | 2006-04-19 |
| 1639602014 | North Mississippi Medical Center, Inc. | Neurological Surgery | 1205 Highway 182 W, Starkville, MS 39759-9820 | 2017-04-04 |
| 1427404235 | North Mississippi Medical Center, Inc. | Social Worker | 961 S Gloster St, Suite A, Tupelo, MS 38801-6343 | 2016-05-11 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | NORTH MISSISSIPPI MEDICAL CENTER, INC. | 830 S Gloster St, Tupelo, MS 38801-4934 |
| Street Address |
4381 S EASON BLVD SUITE 302 |
| City | TUPELO |
| State | MS |
| Zip Code | 38801-6583 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548259013 | Donna Elaine Wesley | Specialist/Technologist | 4381 S Eason Blvd, Tupelo, MS 38801-6583 | 2005-10-18 |
| 1013462258 | Millicent Mcalilly | Social Worker | 4381 S Eason Blvd, Suite 301, Tupelo, MS 38801-6583 | 2016-08-17 |
| 1679943401 | Jeffrey Dews | Specialist/Technologist | 4381 S Eason Blvd, Tupelo, MS 38801-6583 | 2015-10-06 |
| 1588046155 | Devin Fancher | Nurse Practitioner | 4381 S Eason Blvd, Suite 302, Tupelo, MS 38801-6583 | 2015-06-19 |
| 1205249471 | Lori Hall Forrester | Nurse Practitioner | 4381 S Eason Blvd, Suite 302, Tupelo, MS 38801-6583 | 2014-06-05 |
| 1003233727 | Michelle Pruitt | Specialist/Technologist | 4381 S Eason Blvd, Tupelo, MS 38801-6583 | 2014-03-19 |
| 1518393354 | North Mississippi Medical Center, Inc. | Neurological Surgery | 4381 S Eason Blvd, Suite 302, Tupelo, MS 38801-6583 | 2013-09-25 |
| 1497091730 | North Mississippi Medical Center, Inc | Nurse Practitioner | 4381 S Eason Blvd, Suite 201, Tupelo, MS 38801-6583 | 2012-12-13 |
| 1790034254 | Lee Ann Stewart | Physical Therapist | 4381 S Eason Blvd, Tupelo, MS 38801 | 2012-08-30 |
| 1548582455 | Laura Ashley Saia | Physician Assistant | 4381 S Eason Blvd, Tupelo, MS 38801-6583 | 2010-02-18 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194339275 | Friendship, LLC | Pharmacy | 4123 W Main St, Tupelo, MS 38801 | 2020-09-04 |
| 1003443458 | Nicole Sherice Taylor | Nurse Practitioner | 845 South Gloster Street, Tupelo, MS 38801 | 2020-03-25 |
| 1821556838 | Wilco Healthcare of North Mississippi, Pllc | Point of Service | 1514 Co Rd 41, Tupelo, MS 38801 | 2019-03-08 |
| 1821565235 | Stephanie K Cagle | Nurse Practitioner | 218 S Thomas St Ste 120-121, Tupelo, MS 38801 | 2018-10-24 |
| 1073092326 | Lauren Parrish | Nurse Practitioner | 1573 Medical Park Circle, Tupelo, MS 38801 | 2018-08-08 |
| 1467948687 | North Mississippi Medcial Center, Inc. | Nurse Practitioner | 990 S Madison St Ste 2, Tupelo, MS 38801 | 2018-07-11 |
| 1043700933 | Hooks Diabetes & Medicine Clinic | Non-Pharmacy Dispensing Site | 2610 Traceland Drive, Ste A, Tupelo, MS 38801 | 2018-05-16 |
| 1073035903 | Annette C Riddle | Counselor | 1004 Eisenhower Drive, Tupelo, MS 38801 | 2017-07-12 |
| 1548709678 | Jaime Summers | Nurse Practitioner | 2780 West Jackson St, Tupelo, MS 38801 | 2017-02-22 |
| 1073975611 | Heath Bryan Coleman, Dds of Mississippi II, Pllc | Dentist | 1168 Cross Creek Drive, Tupelo, MS 38801 | 2016-03-23 |
| Find all providers in zip 38801 | ||||
| Taxonomy Code | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811969330 | Richard Hunt Bobo | Neurological Surgery | 4381 S Eason Blvd Ste 302, Tupelo, MS 38801-6584 | 2006-02-07 |
| 1215909171 | Carl Gorman Bevering | Neurological Surgery | 4381 S Eason Blvd Ste 602, Tupelo, MS 38801-6583 | 2006-02-06 |
| 1518393354 | North Mississippi Medical Center, Inc. | Neurological Surgery | 4381 S Eason Blvd, Suite 302, Tupelo, MS 38801-6583 | 2013-09-25 |
| 1063777472 | Joaquin Andres Hidalgo | Neurological Surgery | 4381 S Eason Blvd Ste 302, Tupelo, MS 38801-6584 | 2012-07-11 |
| 1780788711 | North Mississippi Medical Clinics | Neurological Surgery | 4381 S Eason Blvd Ste 302, Tupelo, MS 38801-6584 | 2006-09-11 |
| 1811954324 | Elbert White Iv | Neurological Surgery | 4381 S Eason Blvd Ste 602, Tupelo, MS 38801-6583 | 2006-04-27 |
| 1275597288 | Louis Rosa IIi | Neurological Surgery | 4381 S Eason Blvd, Tupelo, MS 38801-6583 | 2006-04-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407173453 | Menarvia Nixon Gaddis | Neurological Surgery | 1860 Chadwick Dr Ste 305, Jackson, MS 39204-3467 | 2010-04-30 |
| 1346485794 | Lon F Alexander Md Pllc | Neurological Surgery | 1860 Chadwick Dr Ste 205, Jackson, MS 39204-3466 | 2008-12-12 |
| 1144349168 | Delta Physician Practices | Neurological Surgery | 1703 Hospital St, Greenville, MS 38703-3225 | 2007-03-29 |
| 1497872212 | Timothy M. Wiebe | Neurological Surgery | 103 Aldersgate Cir, Hattiesburg, MS 39402-1301 | 2007-03-25 |
| 1174686182 | St. Dominic Medical Associates LLC | Neurological Surgery | 971 Lakeland Dr. Suite 1250, Jackson, MS 39216-0000 | 2006-12-19 |
| 1194895854 | Lowry Neurosurgical Clinic, P.a. | Neurological Surgery | 1007 Jefferson St, Laurel, MS 39440-4350 | 2006-11-09 |
| 1831270560 | Axon | Neurological Surgery | 1860 Chadwick Dr Ste 258, Ste 258, Jackson, MS 39204-3486 | 2006-10-18 |
| 1013008242 | John Adrian Lancon | Neurological Surgery | 971 Lakeland Dr Ste 1250, Jackson, MS 39216-4609 | 2006-09-26 |
| 1649378191 | Robert Scott Davis | Neurological Surgery | 14209 Cook Rd., Suite 200, Memorial Physician Clinics-st Martin Neuro & Spine, Biloxi, MS 39532 | 2006-09-20 |
| 1710997135 | Edward Thomas Cullom IIi | Neurological Surgery | 1029 River Oaks Dr, Flowood, MS 39232-9554 | 2006-08-08 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.