NORTH MISSISSIPPI MEDICAL CENTER (NPI# 1730295585) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730295585 |
| Entity Type | Organization |
| Organization Name | NORTH MISSISSIPPI MEDICAL CENTER |
| Other Organization Name | BEHAVIORAL HEALTH CLINIC |
| Practice Address |
4577 S Eason Blvd Ste E F Tupelo MS 38801-6590 |
| Mailing Address |
450 E President Ave Tupelo MS 38801-5599 |
| Practice Telephone | 6623777590 |
| Practice Fax Number | 6623777595 |
| Mailing Telephone | 6623774685 |
| Mailing Fax Number | 6623772755 |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2007-12-11 |
| Authorized Official Name | JOHN HEER JR. (CEO) |
| Authorized Official Telephone | 6623773136 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | RAILROAD MEDICARE | CA5810 | 01 |
| MS | RAILROAD MEDICARE | CJ3596 | 01 |
| MS | 09015827 | 05 |
| Other Name | Type Code |
|---|---|
| Behavioral Health Clinic | 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 |
| 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 |
| 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 |
4577 S EASON BLVD STE E F |
| City | TUPELO |
| State | MS |
| Zip Code | 38801-6590 |
| 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 | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376572123 | Charles Kenneth Lippincott | Psychiatry & Neurology | 4428 South Eason Boulevard, Suite A, Tupelo, MS 38801-6506 | 2006-07-02 |
| 1508893074 | Ross E Collins Jr. | Psychiatry & Neurology | 2434 S Eason Blvd, Tupelo, MS 38804-6942 | 2006-06-28 |
| 1316984149 | Andrea Koosne Garrison | Psychiatry & Neurology | 4577 S Eason Blvd, Tupelo, MS 38801-6590 | 2006-06-01 |
| 1588662720 | Clyde Alexander Sheehan | Psychiatry & Neurology | 1040 B South Madison St., Tupelo, MS 38801 | 2005-07-12 |
| 1508206558 | Demetrio Jose Prota Martinez | Psychiatry & Neurology | 830 S Gloster St, Tupelo, MS 38801 | 2013-07-04 |
| 1164723318 | Aracelis Johanna Lu Brea | Psychiatry & Neurology | 4579 S Eason Blvd, Tupelo, MS 38801-6539 | 2010-11-04 |
| 1649407917 | Chika Uchechukwu Iwueke | Psychiatry & Neurology | 1601 W Main St, Suite D, Tupelo, MS 38801-3334 | 2009-06-15 |
| 1770760357 | Santrise Goree | Psychiatry & Neurology | 4579 S Eason Blvd, Tupelo, MS 38801-6539 | 2008-01-26 |
| 1578654851 | Alena Bess Tyre-littlejohn | Psychiatry & Neurology | Region IIi Mental Health Center, 2434 South Eason Blvd, Tupelo, MS 38804-6942 | 2006-09-28 |
| 1346340858 | Joanne Eleanor Turner | Psychiatry & Neurology | 2434 S Eason Blvd, Tupelo, MS 38804-6942 | 2006-09-24 |
| 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.