Ortho Express Holding Company, LLC
NPI 1497396931ActiveOrganization· Physician Assistant· Southaven, MS
Physician Assistant in Southaven, Mississippi, registered in NPPES in October 2019, part of Orthoxpress Holdings, LLC. The authorized official on file is Jennifer C. Bullock, President. Enrolled in Medicare as dme supplier - physician assistant.
Overview
| NPI | 1497396931 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Orthoxpress Holdings, LLC |
| NPI issued | Oct 7, 2019 |
| Last updated in NPPES | Oct 1, 2025 |
| Certified by provider | Oct 1, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant Primary | 363A00000X | — | — |
| Nurse Practitioner | 363L00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled DME Supplier - Physician Assistant (MS) |
|---|
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