NORTH MISSISSIPPI MEDICAL CENTER (NPI# 1063739290) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063739290 |
| Entity Type | Organization |
| Organization Name | NORTH MISSISSIPPI MEDICAL CENTER |
| Other Organization Name | ADVANCED WOUND CENTER PROFESSIONALS |
| Practice Address |
830 S Gloster St 1st Floor East Tower Tupelo MS 38801-4934 |
| Practice Telephone | 6623772395 |
| Practice Fax Number | 6623772397 |
| Mailing Telephone | 6623772395 |
| Mailing Fax Number | 6623772397 |
| Enumeration Date | 2010-04-28 |
| Last Update Date | 2019-02-21 |
| Authorized Official Name | BRUCE TOPPIN (CORPORATE SECRETARY) |
| Authorized Official Telephone | 6623773000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Advanced Wound Center Professionals | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619238961 | North Mississippi Medical Center | Surgery | 735 Medical Center Dr, West Point, MS 39773-9318 | 2012-06-04 |
| 1730295585 | North Mississippi Medical Center | Psychiatry & Neurology | 4577 S Eason Blvd Ste E F, Tupelo, MS 38801-6590 | 2006-08-22 |
| 1902381908 | North Mississippi Medical Center | Pediatrics | 830 S Gloster St, Tupelo, MS 38801-4934 | 2018-09-26 |
| 1992258255 | North Mississippi Medical Center | Clinic/Center | 1301 N 2nd St, Booneville, MS 38829-1028 | 2016-08-03 |
| 1376960195 | North Mississippi Medical Center | General Acute Care Hospital | 830 S Gloster St, Tupelo, MS 38801-4934 | 2014-03-19 |
| 1376969683 | North Mississippi Medical Center | General Acute Care Hospital | 830 S Gloster St, Tupelo, MS 38801-4934 | 2014-03-11 |
| 1790091304 | North Mississippi Medical Center | Nurse Practitioner | 4566 S Eason Blvd, Tupelo, MS 38801-6540 | 2010-08-20 |
| 1336328715 | North Mississippi Medical Center | Nurse Practitioner | 830 S Gloster St, 1st Floor East Tower, Tupelo, MS 38801-4934 | 2007-11-01 |
| 1295932853 | North Mississippi Medical Center | Surgery | 408 Council Cir, Suite C, Tupelo, MS 38801-4949 | 2007-06-28 |
| 1811089980 | North Mississippi Medical Center | Internal Medicine | 830 S Gloster St, Tupelo, MS 38801-4934 | 2006-09-28 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | NORTH MISSISSIPPI MEDICAL CENTER - PONTOTOC | 176 S Main St, Pontotoc, MS 38863-3311 |
| System for Award Management (SAM) Entities | NORTH MISSISSIPPI MEDICAL CENTER, INC. | 830 S Gloster St, Tupelo, MS 38801-4934 |
| Street Address |
830 S GLOSTER ST 1ST FLOOR EAST TOWER |
| City | TUPELO |
| State | MS |
| Zip Code | 38801-4934 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629078746 | David Smith Talton | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 830 S Gloster St, Nmmc East Tower 4th Floor, Tupelo, MS 38801-4934 | 2005-07-29 |
| 1265031561 | Lauren Hester | Nurse Anesthetist, Certified Registered | 830 S Gloster St, Tupelo, MS 38801-4934 | 2020-10-19 |
| 1972102275 | Matthew Hester | Nurse Anesthetist, Certified Registered | 830 S Gloster St, Tupelo, MS 38801-4934 | 2020-10-19 |
| 1093313397 | Brent Lee Hallmark | Nurse Practitioner | 830 S Gloster St, Tupelo, MS 38801-4934 | 2020-10-09 |
| 1457958282 | Benjamin Johnson | Nurse Anesthetist, Certified Registered | 830 S Gloster St, Tupelo, MS 38801-4934 | 2020-10-05 |
| 1144837451 | Kayla Ann Jenkins | Nurse Practitioner | 830 S Gloster St, Tupelo, MS 38801-4996 | 2020-09-30 |
| 1720695190 | Kimberly Faye Goss | Nurse Practitioner | 830 S Gloster St, Tupelo, MS 38801-4996 | 2020-09-29 |
| 1316554900 | Meaghan Reed | Nurse Practitioner | 830 S Gloster St, Tupelo, MS 38801-4934 | 2020-09-28 |
| 1659988269 | Anna Elizabeth Roberts | Nurse Practitioner | 830 S Gloster St, Tupelo, MS 38801-4934 | 2020-09-28 |
| 1487261954 | Helen Paige Long | Nurse Practitioner | 830 S Gloster St, Tupelo, MS 38801-4934 | 2020-09-28 |
| Find all providers in the same location | ||||
| 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 | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316300080 | Eric Wade Tillotson | Family Medicine | 1665 South Green Street, Tupelo, MS 38804 | 2016-03-31 |
| 1770968919 | Ouch Urgent Care Inc | Family Medicine | 1710 N Gloster St, Tupelo, MS 38804-1216 | 2015-07-29 |
| 1003166745 | North Mississippi Medical Clinics, Inc. | Family Medicine | 1040a S. Madison St, Tupelo, MS 38801-6300 | 2012-09-10 |
| 1073879029 | North Mississippi Medical Clinics, Inc. | Family Medicine | 1680 S Green St, Tupelo, MS 38804-6543 | 2012-04-04 |
| 1992935266 | William T Jennings | Family Medicine | 826 Clayton Ave, Tupelo, MS 38804-1918 | 2009-07-21 |
| 1003059874 | Aaron Ashley Amos | Family Medicine | 1020 N Gloster St # 123, Tupelo, MS 38804-1202 | 2009-04-09 |
| 1083898803 | Raines Atherton Chaffin | Family Medicine | 125 County Road 1698, Tupelo, MS 33804 | 2007-12-28 |
| 1164629747 | North Mississippi Medical Clinics Inc | Family Medicine | 844 S Madison St Ste B, Tupelo, MS 38801-4904 | 2007-06-28 |
| 1295816072 | William M. Hilbun Jr. | Family Medicine | 874 Barnes Crossing Rd, Suite A, Tupelo, MS 38804-0909 | 2006-10-18 |
| 1659399723 | Phillip Edward Jones | Family Medicine | 1200 N Gloster St, Tupelo, MS 38804-1206 | 2006-07-17 |
| Find all providers in TUPELO | ||||
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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.