NPIMap

Organization Active NPI

Shapiro Dimitri Medical, LLC

  • Dermatology Physician
  • Meridian, MS
National Provider Identifier
1124373030
Registry record updated Dec 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
SHAPIRO DIMITRI MEDICAL, LLC
Practice address
1312 22ND Ave
Suite #a
Meridian, MS 39301-4015
Phone
(601) 701-2220
Fax
(601) 483-9520
NPI assigned
Jul 17, 2012
Last updated
Dec 17, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2015

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

Authorized official

Name
Elizabeth M. Dimitri, D.O.NPI 1285700732
Title
Physician/Owner
Phone
(985) 643-4512

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X MS Primary

Addresses

Primary practice location

1312 22ND Ave
Suite #a
Meridian, MS 39301-4015

Mailing address

2104 Gause Blvd W
Suite a
Slidell, LA 70460-4130
Phone (985) 643-4512

National Provider Directory

National Provider Directory

Locations

2104 Gause Blvd W
Ste A
Slidell, LA 70460
Phone (985) 643-4512

300 Gateway Dr
Slidell, LA 70461
Phone (985) 643-4512

1312 22nd Ave
Ste A
Meridian, MS 39301
Phone (504) 465-4550

4105 Hospital St
#102
Pascagoula, MS 39581
Phone (601) 485-1131

Practitioners & affiliated clinicians

Practitioners 34

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.

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1342483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450310400000",
    "number": "1124373030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2104 GAUSE BLVD W",
            "address_2": "SUITE A",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704604130",
            "telephone_number": "985-643-4512",
            "fax_number": "985-643-4513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1312 22ND AVE",
            "address_2": "SUITE #A",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393014015",
            "telephone_number": "601-701-2220",
            "fax_number": "601-483-9520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAPIRO DIMITRI MEDICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-17",
        "last_updated": "2015-12-17",
        "status": "A",
        "authorized_official_last_name": "DIMITRI",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "985-643-4512",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "MS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2015; 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.