La Miss Diabetic Shoes

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

80145 Issued in MS

Legal business name

LA MISS DIABETIC SHOES

Practice address

2200 Highway 61 N
Suite 3400
Vicksburg, MS 39183-8246

Phone

(601) 883-3342

Fax

(601) 856-5955

NPI assigned

Feb 26, 2016

Organization subpart

No

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

Authorized official

Name

Mrs. Stephanie F Phelan, DPMNPI 1962538082

Title

Owner/Provider

Phone

(601) 883-3342

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Stephanie Fay Phelan, D.P.M.

  • Primary Podiatric Medicine Podiatrist
  • Ocean Springs, MS
  • NPI 1962538082
  NPD Authorized official

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

{
    "created_epoch": "1456444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456444800000",
    "number": "1023478435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 SOUTHERN RIDGE DR",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391109484",
            "telephone_number": "601-883-3342",
            "fax_number": "601-856-5955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 HIGHWAY 61 N",
            "address_2": "SUITE 3400",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391838246",
            "telephone_number": "601-883-3342",
            "fax_number": "601-856-5955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA MISS DIABETIC SHOES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-26",
        "last_updated": "2016-02-26",
        "status": "A",
        "authorized_official_last_name": "PHELAN",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "601-883-3342",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MS",
            "license": "80145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• KPC Promise Hospital of Vicksburg LLC
• Kristi Kraft
• Kroger Limited Partnership I (Kroger Pharmacy)
• Kroger Limited Partnership I (Kroger Pharmacy)
• Allison Kurtz
• Lorletha Lacy
• Toni L Ladner, PMHNP-BC
• Edith Nicolle Lambert, NP-C
• Suzanne Lancaster, LPC
• Keera Quantae Lane

• Durable Medical Equipment & Medical Supplies in Vicksburg, MS
• Providers in Vicksburg, MS by specialty
• Durable Medical Equipment & Medical Supplies in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2016; 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.