NPIMap

Organization Active NPI

Durable Medical Equipment

Doing business as Center for Diabetes Foot Care

  • Durable Medical Equipment & Medical Supplies
  • Jackson, MS
National Provider Identifier
1073540654
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
DURABLE MEDICAL EQUIPMENT
Doing business as
Center for Diabetes Foot Care
Practice address
820 Cooper Rd
Suite I
Jackson, MS 39212-4099
Phone
(601) 372-9575
Fax
(601) 376-0404
NPI assigned
Jun 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Kathleen Evans Reed
Title
Executive Director
Phone
(601) 372-9575

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

820 Cooper Rd
Suite I
Jackson, MS 39212-4099

Mailing address

820 Cooper Rd
Suite I
Jackson, MS 39212-4099
Phone (601) 372-9575

Other identifiers 1

IdentifierTypeStateIssuer
09015701MedicaidMS

Other names 1

  • CENTER FOR DIABETES FOOT CARE Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Center for Diabetes Foot Care2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073540654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 COOPER RD",
            "address_2": "SUITE I",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392124099",
            "telephone_number": "601-372-9575",
            "fax_number": "601-376-0404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 COOPER RD",
            "address_2": "SUITE I",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392124099",
            "telephone_number": "601-372-9575",
            "fax_number": "601-376-0404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DURABLE MEDICAL EQUIPMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "REED",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "EVANS",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "601-372-9575",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09015701",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CENTER FOR DIABETES FOOT CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.