NPIMap

Organization Active NPI

MDB Care Management LLC

  • Primary Care Nurse Practitioner
  • Flowood, MS
National Provider Identifier
1144925272
Registry record updated Mar 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
Legal business name
MDB CARE MANAGEMENT LLC
Practice address
215 Katherine Dr
Flowood, MS 39232-9588
Phone
(601) 665-4162
Fax
(855) 830-3484
NPI assigned
Mar 30, 2023
Last updated
Mar 30, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2023

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

Authorized official

Name
John Duke
Title
Coo
Phone
(601) 665-4162

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X Primary

Addresses

Primary practice location

215 Katherine Dr
Flowood, MS 39232-9588

Mailing address

215 Katherine Dr
Flowood, MS 39232-9588
Phone (601) 665-4162

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231215002106 MS Part B Supplier - Clinic/Group Practice 0547619512 Receives reassigned benefits from 89 practitioners
Practice locations: Flowood, MS

National Provider Directory

National Provider Directory

Locations

215 Katherine Dr
Flowood, MS 39232

Practitioners & affiliated clinicians

Practitioners 104

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 104

NPI Registry JSON

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

{
    "created_epoch": "1680134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680134400000",
    "number": "1144925272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 KATHERINE DR",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329588",
            "telephone_number": "601-665-4162",
            "fax_number": "855-830-3484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 KATHERINE DR",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329588",
            "telephone_number": "601-665-4162",
            "fax_number": "855-830-3484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MDB CARE MANAGEMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-30",
        "last_updated": "2023-03-30",
        "certification_date": "2023-03-30",
        "status": "A",
        "authorized_official_last_name": "DUKE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "601-665-4162"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flowood, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2023; 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.