NPIMap

Organization Active NPI

Mid-South Anesthesia Consultants, PLLC

  • Specialist
  • Southaven, MS
National Provider Identifier
1003869520
Registry record updated Oct 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
MID-SOUTH ANESTHESIA CONSULTANTS, PLLC
Practice address
7601 Southcrest Pkwy
Southaven, MS 38671-4739
Phone
(334) 386-2053
Fax
(334) 244-1830
NPI assigned
May 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Terrie L. Carleton
Title
Account Manager
Phone
(334) 386-2053

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

7601 Southcrest Pkwy
Southaven, MS 38671-4739

Mailing address

PO Box 235022
Montgomery, AL 36123-5022
Phone (334) 386-2053

Other identifiers 2

IdentifierTypeStateIssuer
09015515MedicaidMS
CB3549OtherMSRAILROAD MEDICARE GRP #

National Provider Directory

National Provider Directory

Locations

7603 Southcrest Pkwy
Ste 100
Southaven, MS 38671
Phone (662) 349-0142

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 13

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223510400000",
    "number": "1003869520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 235022",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361235022",
            "telephone_number": "334-386-2053",
            "fax_number": "334-244-1830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7601 SOUTHCREST PKWY",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386714739",
            "telephone_number": "334-386-2053",
            "fax_number": "334-244-1830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-SOUTH ANESTHESIA CONSULTANTS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2008-10-09",
        "status": "A",
        "authorized_official_last_name": "CARLETON",
        "authorized_official_first_name": "TERRIE",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "ACCOUNT MANAGER",
        "authorized_official_telephone_number": "334-386-2053"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09015515",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GRP #",
            "identifier": "CB3549",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southaven, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.