Organization · Type 2 NPI

Ortho Express Holding Company, LLC

Nurse Practitioner · Booneville, MS

NPI number 1962029249 Active

Practice location

608 W Church St
Booneville, MS 38829

Call (662) 534-2227 Map

Fax (662) 534-2330

Mailing address

206 Oxford Rd
New Albany, MS 38652-3115

Specialties and licenses

Taxonomy	Code	License
Medical Specialty Clinic/Center	261QM2500X	None listed
Physician Assistant	363A00000X	None listed
Nurse Practitioner Primary	363L00000X	None listed

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

NPI record

NPI: 1962029249
Entity type: Organization (Type 2)
Issued: Jul 2, 2020
Last updated: Sep 10, 2025
Status: Active

Other names

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Orthoxpress Bone & Joint Center of Booneville · doing business as
Orthoxpress Bone & Joint Center of Booneville · doing business as

Authorized official

Jennifer C Bullock
President
(662) 534-2227

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1962029249

Ortho Express Holding Company, LLC's National Provider Identifier is 1962029249, issued on Jul 2, 2020. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Booneville, MS. The record was last updated on Sep 10, 2025.