ORTHO EXPRESS HOLDING COMPANY, LLC (NPI# 1497396931) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497396931 |
| Entity Type | Organization |
| Organization Name | ORTHO EXPRESS HOLDING COMPANY, LLC |
| Other Organization Name | ORTHOXPRESS OF SOUTHAVEN |
| Practice Address |
125 Goodman Rd W Ste D Southaven MS 38671-9481 |
| Mailing Address |
206 Oxford Rd New Albany MS 38652-3115 |
| Practice Telephone | 6629323560 |
| Practice Fax Number | 6625342330 |
| Mailing Telephone | 6625342227 |
| Enumeration Date | 2019-10-07 |
| Last Update Date | 2020-10-06 |
| Authorized Official Name | JENNIFER C BULLOCK (PRESIDENT) |
| Authorized Official Telephone | 6625342227 |
| Is Organization Subpart | Y |
| Parent Organization Name | ORTHO EXPRESS HOLDING COMPANY, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| OrthoXpress of Southaven | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962029249 | Ortho Express Holding Company, LLC | Clinic/Center | 608 W Church St, Booneville, MS 38829 | 2020-07-02 |
| 1780218289 | Ortho Express Holding Company, LLC | Podiatrist | 3952 N Gloster St Ste C, Tupelo, MS 38804-0913 | 2020-02-24 |
| 1518527688 | Ortho Express Holding Company, LLC | Podiatrist | 1200 Office Park Dr, Oxford, MS 38655-3597 | 2019-06-19 |
| 1629596804 | Ortho Express Holding Company, LLC | Orthopaedic Surgery | 173a Whaley Dr, Ste B, Holly Springs, MS 38635 | 2017-09-07 |
| 1720506264 | Ortho Express Holding Company, LLC | Orthopaedic Surgery | 3952c N Gloster St, Tupelo, MS 38804-0913 | 2017-09-05 |
| 1578189973 | Ortho Express Holding Company, LLC | Clinic/Center | 806 Earl Frye Blvd, Amory, MS 38821-5505 | 2020-06-22 |
| 1710545439 | Ortho Express Holding Company, LLC | Orthopaedic Surgery | 101 Wilburn Way, Starkville, MS 39759-3693 | 2019-05-29 |
| 1649748252 | Ortho Express Holding Company, LLC | Orthopaedic Surgery | 2601 Getwell Rd Ste 4, Corinth, MS 38834-6762 | 2018-11-13 |
| Street Address |
125 GOODMAN RD W STE D |
| City | SOUTHAVEN |
| State | MS |
| Zip Code | 38671-9481 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215189618 | Brandye Nicole Wilson | Physician Assistant | 125 Goodman Rd W Ste D, Southaven, MS 38671-9481 | 2008-10-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285196196 | Emma Tinsley-bowles Long | Social Worker | 8786 Northcreek Blvd, Bldg 8 Apt 3, Southaven, MS 38671 | 2019-04-01 |
| 1851847586 | Tiffany Lashea Jones | Adult Companion | 8755 Millbranch Road, Southaven, MS 38671 | 2016-09-01 |
| 1538526140 | Desoto Pediatric Extended Care LLC | Skilled Nursing Facility | 750 Stateline Road East, Southhaven, MS 38671 | 2016-01-27 |
| 1073983052 | Tara Burt | Physical Therapist | 7900 Airways Blvd. Building A, Suite 2, Southaven, MS 38671 | 2015-10-02 |
| 1295160463 | Ideal Community Care,llc | In Home Supportive Care | 8869 Centre Str #3, Southaven, MS 38671 | 2013-09-06 |
| 1578995692 | Gregory Charles Eakins Jr. | Optometrist | 338 Goodman Rd West, Southaven, MS 38671 | 2013-07-31 |
| 1295173169 | Erica R. Martin | Social Worker | 975 Swinnea Rdg Ste 3, Southaven, MS 38671 | 2013-06-12 |
| 1386918431 | Freds Stores of Tennessee Inc | Pharmacy | 710 Church Road, Southaven, MS 38671 | 2012-03-06 |
| 1740565613 | Mary Jeanette Scruggs | Pharmacist | 1011 Goodman Rd, Southaven, MS 38671 | 2011-10-11 |
| 1184919268 | First Pharmacy Services 5 | Pharmacy | 5185a Getwell Rd, Southaven, MS 38671 | 2011-06-16 |
| Find all providers in zip 38671 | ||||
| Taxonomy Code | 207XX0005X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Sports Medicine |
| An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source changed] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. ACGME Accredited Program Requirements: 1 year GME in the specialty + 5 years of Orthopaedic Surgery for a total of 6 years |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407263056 | Marie Joyce Barron | Orthopaedic Surgery | 7545 Airways Blvd, Southaven, MS 38671-5806 | 2014-07-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821585241 | Jazzma Trice | Orthopaedic Surgery | 4381 S Eason Blvd Ste 303, Tupelo, MS 38801-6584 | 2018-04-20 |
| 1629596804 | Ortho Express Holding Company, LLC | Orthopaedic Surgery | 173a Whaley Dr, Ste B, Holly Springs, MS 38635 | 2017-09-07 |
| 1720506264 | Ortho Express Holding Company, LLC | Orthopaedic Surgery | 3952c N Gloster St, Tupelo, MS 38804-0913 | 2017-09-05 |
| 1477789964 | Letonoff Orthopaedics & Sports | Orthopaedic Surgery | 452 Court House Road, Suite G, Gulfport, MS 39507 | 2009-06-10 |
| 1063624948 | Richard D. Rainey | Orthopaedic Surgery | 1211 South Gloster, Suite A, Tupelo, MS 38801 | 2007-05-04 |
| 1053530246 | Orthoone Sports Medicine & Orthopaedics, Pllc | Orthopaedic Surgery | 9085 E Sandidge Cv, Suite 200, Olive Branch, MS 38654-3575 | 2007-04-25 |
| 1144209727 | Martin M Pomphrey Jr. | Orthopaedic Surgery | 307 Hospital Rd, Starkville, MS 39759-2155 | 2006-01-12 |
| 1710545439 | Ortho Express Holding Company, LLC | Orthopaedic Surgery | 101 Wilburn Way, Starkville, MS 39759-3693 | 2019-05-29 |
| 1821490723 | The University of Southern Mississippi | Orthopaedic Surgery | 118 College Dr, 5017, Hattiesburg, MS 39406-0002 | 2014-09-23 |
| 1760627996 | Glenn Anthony Brien Jr. | Orthopaedic Surgery | 104 Burney Dr, Flowood, MS 39232-6621 | 2008-12-02 |
| Find all providers with the same taxonomy | ||||
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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.