Dermatology Clinic of North Mississippi, P.L.L.C.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

16501 Issued in MS

Legal business name

DERMATOLOGY CLINIC OF NORTH MISSISSIPPI, P.L.L.C.

Practice address

7585 Claringto Cove
Southaven, MS 38671-5834

Phone

(662) 349-0200

Fax

(662) 349-1666

NPI assigned

Dec 21, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Terri H. Henson, M.D.NPI 1558361345

Title

Managing Member

Phone

(662) 349-0200

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Locations

Practitioners 5

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

• Terri Hayes Henson, MD

  • Dermatology Physician
  • Southaven, MS
  • NPI 1558361345

  Dermatology, MS

  Medicare reassignment Care Compare group NPD Authorized official
• Carley Crosby, PA-C

  • Physician Assistant
  • Southaven, MS
  • NPI 1811708597

  MS

  Medicare reassignment Care Compare group
• Lisa Thompson Kirk, PA-C

  • Physician Assistant
  • Southaven, MS
  • NPI 1699430637

  MS

  Medicare reassignment Care Compare group
• Caroline Sabbatini Moreland, PA-C

  • Physician Assistant
  • Collierville, TN
  • NPI 1356929624

  MS

  Medicare reassignment
• Sara Streete

  • Physician Assistant
  • Southaven, MS
  • NPI 1205780251
  NPD

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609977600000",
    "number": "1104980432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7585 CLARINGTON CV",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386715656",
            "telephone_number": "662-349-0200",
            "fax_number": "662-349-1666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7585 CLARINGTO COVE",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386715834",
            "telephone_number": "662-349-0200",
            "fax_number": "662-349-1666"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2778 Highway 51 S",
            "address_purpose": "LOCATION",
            "city": "Senatobia",
            "state": "MS",
            "postal_code": "386689403",
            "country_code": "US",
            "telephone_number": "662-349-0200",
            "fax_number": "662-349-1666",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DERMATOLOGY CLINIC OF NORTH MISSISSIPPI, P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-21",
        "last_updated": "2021-01-07",
        "certification_date": "2021-01-07",
        "status": "A",
        "authorized_official_last_name": "HENSON",
        "authorized_official_first_name": "TERRI",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "662-349-0200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "MS",
            "license": "16501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09015946",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "thenson@directaddress.net",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "ccda / xml",
            "address_1": "7585 Claringto Cove",
            "city": "Southaven",
            "state": "MS",
            "country_code": "US",
            "postal_code": "386715834",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Deadra Dennis
• Patience Dennis, RBT
• Nathaniel D Denson, D.D.S.
• Dental Professionals of Mississippi, P.C.
• Lisa Deptula, PA, MD
• Desoto Adult Medicine Associates, PLLC
• Desoto County Chiropractic, Inc.
• Desoto County School
• Desoto Dna and Diagnostic Center
• Desoto Eye and Ear

• All providers in Southaven, MS
• Dermatology Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.