NPIMap

Organization Active NPI

Greenwood Clinic for Women PLLC

  • Obstetrics & Gynecology Physician
  • Greenwood, MS
National Provider Identifier
1073695839
Registry record updated Apr 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
GREENWOOD CLINIC FOR WOMEN PLLC
Practice address
1604 Leflore Ave
Greenwood, MS 38930
Phone
(662) 453-0532
Fax
(662) 453-3079
NPI assigned
Oct 20, 2006
Last updated
Apr 28, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2008

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

Authorized official

Name
Sr Evans Jr., MDNPI 1598847253
Title
Vice President
Phone
(662) 453-0532

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MS Primary

Addresses

Primary practice location

1604 Leflore Ave
Greenwood, MS 38930

Mailing address

1604 Leflore Ave
Greenwood, MS 38930
Phone (662) 453-0532

Other identifiers 1

IdentifierTypeStateIssuer
09016047MedicaidMS

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209340800000",
    "number": "1073695839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1604 LEFLORE AVE",
            "city": "GREENWOOD",
            "state": "MS",
            "postal_code": "38930",
            "telephone_number": "662-453-0532",
            "fax_number": "662-453-3079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1604 LEFLORE AVE",
            "city": "GREENWOOD",
            "state": "MS",
            "postal_code": "38930",
            "telephone_number": "662-453-0532",
            "fax_number": "662-453-3079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENWOOD CLINIC FOR WOMEN PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-20",
        "last_updated": "2008-04-28",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "SR",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "662-453-0532",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09016047",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 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.