MAGNOLIA ORTHOPAEDICS & SPORTS MEDICINE, P.A.
NPI 1063433233
Orthopaedic Surgery - Sports Medicine in Corinth, MS

Q: What is Magnolia Orthopaedics & Sports Medicine, P.A.'s specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Sports Medicine, with taxonomy code 207XX0005X.

Active since July 22, 2006

611 ALCORN DR, SUITE 100, CORINTH, MS 38834(662) 286-6369(662) 286-2768 Get Directions Write a Review

NPPES record last updated: August 15, 2013. Verified against the NPPES registry weekly; last sync: November 01, 2026.

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About Magnolia Orthopaedics & Sports Medicine, P.a. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MAGNOLIA ORTHOPAEDICS & SPORTS MEDICINE, P.A. (NPI 1063433233) is a healthcare organization registered as a sports medicine in Corinth, Mississippi and active in the NPI registry since July 2006. The organization lists Charlie Gooch, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1063433233

Entity TypeOrganization

Primary Taxonomy207XX0005X

Legal Business NameMAGNOLIA ORTHOPAEDICS & SPORTS MEDICINE, P.A.

Location Address611 ALCORN DR, SUITE 100Corinth, MS 38834-9321

Mailing Address611 Alcorn Dr, Suite 100Corinth, MS 38834-9321 · (662) 286-6369 · Fax (662) 286-2768

Phone(662) 286-6369

Fax(662) 286-2768

Organization SubpartNo

Authorized OfficialCharlie GoochOffice Manager · (662) 286-6369

Enumeration DateJuly 22, 2006

Last NPPES UpdateAugust 15, 2013

✔ NPI 1063433233 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic Surgery · Sports MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207XX0005X

Definition

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.

611 ALCORN DR, Corinth, MS 38834

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Other Identifiers 2

Medicare NSC0381770001MS

Medicaid09013928MS

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Magnolia Orthopaedics & Sports Medicine, P.a. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by January 31, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date

StateMississippiEnrollment IDO20090818000406Non-DME Part B · Clinic/Group PracticeDue dateJanuary 31, 2027

Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 7 clinicians reassign Medicare billing to Magnolia Orthopaedics & Sports Medicine, P.A., which bills Medicare for the services they deliver. Of these, 4 practice at this address and 5 within 10 miles. They are listed nearest first.

Clinicians, nearest first (7)

Brittany Bryant, F.N.P.

Nurse Practitioner

NPI 1124305479

611 ALCORN DR SUITE 100
Corinth, MS 38834

(662) 286-6369

✔ PECOS✔ Accepts MedicareSame address

John Foropoulos, M.D.

Orthopedic Surgery

NPI 1528089794

611 ALCORN DR SUITE 100
Corinth, MS 38834

(662) 286-6369

✔ PECOS✔ Accepts MedicareSame address

Randall Frazier, M.D.

Orthopedic Surgery

NPI 1851314033

611 ALCORN DR SUITE 100
Corinth, MS 38834

(662) 286-6369

✔ PECOS✔ Accepts MedicareSame address

James Long, MD

Plastic and Reconstructive Surgery

NPI 1598795957

611 ALCORN DR STE 100
Corinth, MS 38834

(205) 532-0316

✔ PECOS✔ Accepts MedicareSame address

Amanda Barnett, FNP-BC

Nurse Practitioner

NPI 1447969159

611 ALCORN DR STE 100
Corinth, MS 38834

(662) 594-6381

✔ PECOS✔ Accepts Medicare0.1 mi

Wendy Mcclain, D.P.M.

Podiatry

NPI 1154640878

109 W 6TH ST
Cookeville, TN 38501

(931) 559-3668

✔ PECOS✔ Accepts Medicare192 mi

Bruce Senter, MD

Orthopedic Surgery

NPI 1790993319

971 LAKELAND DR SUITE 950
Jackson, MS 39216

(601) 982-7811

✔ PECOS202 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Magnolia Orthopaedics & Sports Medicine, P.A.'s NPI number?

The NPI number for Magnolia Orthopaedics & Sports Medicine, P.A. is 1063433233. It was assigned to this organization in the NPPES registry on July 22, 2006.

Where is Magnolia Orthopaedics & Sports Medicine, P.A. located?

Magnolia Orthopaedics & Sports Medicine, P.A. is located at 611 Alcorn Dr Suite 100, Corinth, MS 38834. The listed phone number is (662) 286-6369.

What is Magnolia Orthopaedics & Sports Medicine, P.A.'s specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Sports Medicine, with taxonomy code 207XX0005X.

Is Magnolia Orthopaedics & Sports Medicine, P.A. enrolled in Medicare?

Yes. Magnolia Orthopaedics & Sports Medicine, P.A. is registered in the Medicare PECOS enrollment system.

When is Magnolia Orthopaedics & Sports Medicine, P.A.'s Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Mississippi, Clinic/Group Practice) is due for revalidation by January 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Magnolia Orthopaedics & Sports Medicine, P.A.?

According to the CMS Revalidation Reassignment List (October 2026 release), 7 clinicians in 4 Medicare specialties reassign their Medicare billing to Magnolia Orthopaedics & Sports Medicine, P.A.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Orthopedic Surgery (3), Nurse Practitioner (2) and Plastic and Reconstructive Surgery (1). Of these, 4 practice at this address and 5 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Magnolia Orthopaedics & Sports Medicine, P.A. accept?

Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter of Alabama and Ambetter of Tennessee and 2 other insurers list Magnolia Orthopaedics & Sports Medicine, P.A. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Magnolia Orthopaedics & Sports Medicine, P.A. was last updated on August 15, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.