NORTH MISSISSIPPI MEDICAL CENTER (NPI# 1790091304) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1790091304 |
Entity Type | Organization |
Organization Name | NORTH MISSISSIPPI MEDICAL CENTER |
Other Organization Name | OB/GYN NURSE PRACTITIONERS |
Practice Address |
4566 S Eason Blvd Tupelo MS 38801-6540 |
Practice Telephone | 6623774962 |
Practice Fax Number | 6623772257 |
Mailing Telephone | 6623774962 |
Mailing Fax Number | 6623772257 |
Enumeration Date | 2010-08-20 |
Last Update Date | 2010-08-20 |
Authorized Official Name | MR. JOSEPH A REPPERT (CFO) |
Authorized Official Telephone | 6623773000 |
Is Organization Subpart | Y |
Parent Organization Name | NORTH MISSISSIPPI MEDICAL CENTER |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LX0001X |
Nurse Practitioner Specialization: Obstetrics & Gynecology |
Physician Assistants & Advanced Practice Nursing Providers |
Other Name | Type Code |
---|---|
OB/Gyn Nurse Practitioners | 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 |
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 |
4566 S EASON BLVD |
City | TUPELO |
State | MS |
Zip Code | 38801-6540 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1235102906 | Ginger L Pole | Pediatrics | 4566 S Eason Blvd, Tupelo, MS 38801-6540 | 2006-02-10 |
1588277685 | Bianca Ho | Registered Nurse | 4566 S Eason Blvd, Tupelo, MS 38801-6540 | 2020-08-28 |
1366062572 | Tanya Underwood | Registered Nurse | 4566 S Eason Blvd, Tupelo, MS 38801-6540 | 2020-04-17 |
1528688819 | Carleigh Ballard | Registered Nurse | 4566 S Eason Blvd, Tupelo, MS 38801-6540 | 2020-04-16 |
1679109458 | Kari Anna Adams | Nurse Practitioner | 4566 S Eason Blvd, Tupelo, MS 38801-6540 | 2020-03-12 |
1467095869 | Jessica Braddock Childs | Registered Nurse | 4566 S Eason Blvd, Tupelo, MS 38801-6540 | 2019-10-18 |
1376107409 | Susan Long Newell | Registered Nurse | 4566 S Eason Blvd, Tupelo, MS 38801-6540 | 2019-04-24 |
1922445188 | North Mississippi Medical Center, Inc. | Obstetrics & Gynecology | 4566 S Eason Blvd, Tupelo, MS 38801-6540 | 2013-05-29 |
1700141074 | Jennifer Caldwell | Nurse Practitioner | 4566 S Eason Blvd, Tupelo, MS 38801-6540 | 2012-07-11 |
1174817340 | Preeti Singh | Pediatrics | 4566 S Eason Blvd, Tupelo, MS 38801-6540 | 2011-06-06 |
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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 | 363LX0001X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Obstetrics & Gynecology |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1669450425 | Melissa L Barnett | Nurse Practitioner | 1793 Cliff Gookin Blvd, Tupelo, MS 38801-6723 | 2006-01-03 |
1801867940 | Emily Orgler | Nurse Practitioner | 1793 Cliff Gookin Blvd, Tupelo, MS 38801-6723 | 2006-01-27 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1750868691 | Katherine Walters | Nurse Practitioner | 501 Marshall St., Suite 400, Jackson, MS 39202 | 2018-07-24 |
1669762902 | Stacey Marie Kreher | Nurse Practitioner | 1009 Benigno Ln., Hancock Women's Center, Bay St. Louis, MS 39520 | 2011-04-07 |
1174755359 | Innovative Health LLC | Nurse Practitioner | 501 Marshall St Ste 605, Jackson, MS 39202-1650 | 2009-08-20 |
1891814802 | Delta Physician Practices | Nurse Practitioner | 302 Arnold Ave, Greenville, MS 38701-4711 | 2007-03-29 |
1629116330 | Jean Lawes | Nurse Practitioner | 701 Yalobusha St, Greenwood, MS 38930-2015 | 2007-02-02 |
1831619626 | Erica Clanahan | Nurse Practitioner | 2124 14th St, Meridian, MS 39301-4040 | 2017-06-22 |
1699157487 | Jada Elyse Vierling Hill | Nurse Practitioner | 715a Division St, Biloxi, MS 39530-2209 | 2015-06-29 |
1396017646 | Mary K Fouquier | Nurse Practitioner | 1207 N West St, Jackson, MS 39202-2018 | 2012-02-02 |
1407157118 | Carolann Risley | Nurse Practitioner | 4600 Vega St, Pascagoula, MS 39581-5303 | 2010-11-11 |
1639497878 | Diane H. Phillips | Nurse Practitioner | 1050 River Oaks Dr, Suite 200, Flowood, MS 39232-9564 | 2010-05-12 |
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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.