NORTH MISSISSIPPI MEDICAL CENTER (NPI# 1336328715) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336328715 |
| Entity Type | Organization |
| Organization Name | NORTH MISSISSIPPI MEDICAL CENTER |
| Other Organization Name | GLYCEMIC CONTROL CENTER |
| Practice Address |
830 S Gloster St 1st Floor East Tower Tupelo MS 38801-4934 |
| Mailing Address |
450 E President Ave Tupelo MS 38801-5599 |
| Practice Telephone | 6623772500 |
| Practice Fax Number | 6623772069 |
| Mailing Telephone | 6623774685 |
| Mailing Fax Number | 6623772755 |
| Enumeration Date | 2007-11-01 |
| Last Update Date | 2007-11-01 |
| Authorized Official Name | GERALD WAGES (TREASURER) |
| Authorized Official Telephone | 6623773000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | MEDICARE GROUP | C03168 | 01 |
| Other Name | Type Code |
|---|---|
| Glycemic Control Center | 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 |
| 1063739290 | North Mississippi Medical Center | Family Medicine | 830 S Gloster St, 1st Floor East Tower, Tupelo, MS 38801-4934 | 2010-04-28 |
| 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 | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336789387 | Michelle Gardner Briley | Nurse Practitioner | 341 E Main St Ste A1, Tupelo, MS 38804-4040 | 2020-01-07 |
| 1891347522 | Lisa Pierce | Nurse Practitioner | 913 Holly Hill Dr, Tupelo, MS 38801-2361 | 2019-07-12 |
| 1821565235 | Stephanie K Cagle | Nurse Practitioner | 218 S Thomas St Ste 120-121, Tupelo, MS 38801 | 2018-10-24 |
| 1467948687 | North Mississippi Medcial Center, Inc. | Nurse Practitioner | 990 S Madison St Ste 2, Tupelo, MS 38801 | 2018-07-11 |
| 1992234959 | Pro Health Clinic,llc | Nurse Practitioner | 4127 W Main St, Tupelo, MS 38801-8129 | 2017-06-05 |
| 1053845610 | Precious Montgomery | Nurse Practitioner | 173 Carr Vista Rd, Tupelo, MS 38801-8604 | 2017-04-20 |
| 1548709678 | Jaime Summers | Nurse Practitioner | 2780 West Jackson St, Tupelo, MS 38801 | 2017-02-22 |
| 1528465424 | Advanced Diabetes Management Center LLC | Nurse Practitioner | 449 Gloster Creek, Suite H-9, Tupelo, MS 38801-0000 | 2014-11-21 |
| 1699051508 | Angela Sima Clegg | Nurse Practitioner | 942 Commonwealth Blvd, Tupelo, MS 38804-9762 | 2011-10-25 |
| 1427299213 | Kathi Ann Hood Tomsky | Nurse Practitioner | 2071 S Green St, Tupelo, MS 38804-6512 | 2009-03-09 |
| 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.