MID SOUTH PSYCH SERVICES, PLLC
NPI 1558856609
Nurse Practitioner - Psychiatric/Mental Health in Bolivar, TN
About Mid South Psych Services, Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MID SOUTH PSYCH SERVICES, PLLC (NPI 1558856609) is a healthcare organization registered as a psychiatric/mental health in Bolivar, Tennessee and active in the NPI registry since June 2018. The organization lists Mary Jane Allen, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mid South Psych Services, Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Mid South Psych Services, PLLC, which bills Medicare for the services they deliver. They are listed nearest first.
Clinicians, nearest first (2)
Covington, TN 38019
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 Mid South Psych Services, PLLC's NPI number?
The NPI number for Mid South Psych Services, PLLC is 1558856609. It was assigned to this organization in the NPPES registry on June 29, 2018.
Where is Mid South Psych Services, PLLC located?
Mid South Psych Services, PLLC is located at 206 Stevens Rd, Bolivar, TN 38008. The listed phone number is (731) 609-6096.
What is Mid South Psych Services, PLLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Mid South Psych Services, PLLC enrolled in Medicare?
Yes. Mid South Psych Services, PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Mid South Psych Services, PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Mid South Psych Services, PLLC. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Mid South Psych Services, PLLC was last updated on June 29, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.
# Mid South Psych Services, Pllc · NPI 1558856609
Psychiatric/Mental Health organization in Bolivar, Tennessee. Organization record, active in the CMS NPPES registry since June 29, 2018.
## Identity
- **NPI:** 1558856609 (Entity type: Organization)
- **Enumerated:** June 29, 2018
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **Organization subpart:** No
- **Authorized official:** Mary Allen, OWNER
## Practice location
- **Address:** 206 STEVENS RD, Bolivar, TN 38008-1120
- **Phone:** (731) 609-6096 · **Fax:** (865) 246-2106
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians (Nurse Practitioner) reassign Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** June 29, 2018
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Source: [NPI Profile](https://npiprofile.com/npi/1558856609) · Data from the CMS NPPES public registry.