NORTH MISSISSIPPI MEDICAL CENTER (NPI# 1902381908) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902381908 |
| Entity Type | Organization |
| Organization Name | NORTH MISSISSIPPI MEDICAL CENTER |
| Practice Address |
830 S Gloster St Tupelo MS 38801-4934 |
| Mailing Address |
808 Varsity Dr Tupelo MS 38801-4613 |
| Practice Telephone | 6623773000 |
| Mailing Telephone | 8004537536 |
| Enumeration Date | 2018-09-26 |
| Last Update Date | 2018-09-26 |
| Authorized Official Name | BRUCE TOPPIN (SECRETARY) |
| Authorized Official Telephone | 6623773000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 08677225 | 05 |
| Other Name | Type Code |
|---|---|
| NMMC Health Providers | 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 |
| 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 |
830 S GLOSTER ST |
| 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 |
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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 | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235635566 | North Mississippi Medcial Center, Inc. | Pediatrics | 1150 S Green St Ste D, Tupelo, MS 38804-4901 | 2018-04-04 |
| 1093912479 | Jessica Lilley | Pediatrics | 330 W Jefferson St, Tupelo, MS 38804-3936 | 2007-06-29 |
| 1598847428 | John H Nading | Pediatrics | 4566 South Eason Blvd, Tupelo, MS 38801 | 2006-10-19 |
| 1639187024 | North Mississippi Pediatrics Pa | Pediatrics | 1573 Medical Park Cr, Tupelo, MS 38801 | 2006-08-03 |
| 1821018144 | Thomas A Ireland | Pediatrics | 1573 Medical Park Cir, Tupelo, MS 38801-6580 | 2006-07-20 |
| 1275597544 | Children's Clinic of Tupelo, Pa | Pediatrics | 458 E President Ave, Tupelo, MS 38801-5515 | 2006-04-13 |
| 1689074395 | North Mississippi Medical Center Inc. | Pediatrics | 830 S Gloster St, Tupelo, MS 38801-4934 | 2014-08-29 |
| 1558776401 | Jhoclay Chu See | Pediatrics | 830 S Gloster St, Tupelo, MS 38801-4934 | 2014-06-29 |
| 1578766374 | Alexa Nicole Ivancic | Pediatrics | 499 Gloster Creek Vlg, Suite H-3, Tupelo, MS 38801-4600 | 2007-06-08 |
| 1891906657 | Eric Street | Pediatrics | 1573 Medical Park Cir, Tupelo, MS 38801-6580 | 2007-05-24 |
| 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.