Delta Heart & Vascular Center, P.a.

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

DELTA HEART & VASCULAR CENTER, P.A.

Practice address

1421 E Union St
Greenville, MS 38703-3247

Phone

(662) 335-0183

Fax

(662) 335-7184

NPI assigned

Nov 22, 2005

Last updated

May 20, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

John L HerzogNPI 1093734949

Title

Ceo/MD

Phone

(662) 335-0183

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Locations

Practitioners 6

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.

• John L Herzog Sr., MD

  • Cardiovascular Disease Physician
  • Greenville, MS
  • NPI 1093734949
  Medicare reassignment Care Compare group NPD Authorized official
• Casey Pittman Nelson, FNP-C

  • Primary Care Nurse Practitioner
  • Glen Allan, MS
  • NPI 1477135267
  Medicare reassignment Care Compare group NPD
• Dawn Caprice Peery, NP-C

  • Family Nurse Practitioner
  • Flowood, MS
  • NPI 1871844498
  Medicare reassignment Care Compare group NPD
• Kyle T Christopher

  • Physician Assistant
  • Greenville, MS
  • NPI 1770021982
  Medicare reassignment Care Compare group
• Melissa S Baker, RPA/RA

  • Radiology Practitioner Assistant
  • Greenville, MS
  • NPI 1407156730
  NPD (past)
• Michael Joseph Cirilli, MD

  • Internal Medicine Physician
  • Greenville, MS
  • NPI 1669598561
  NPD (past)

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

{
    "created_epoch": "1132617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621468800000",
    "number": "1174506281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1421 E UNION ST",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "387033247",
            "telephone_number": "662-335-0183",
            "fax_number": "662-335-7184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1421 E UNION ST",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "387033247",
            "telephone_number": "662-335-0183",
            "fax_number": "662-335-7184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELTA HEART & VASCULAR CENTER, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-22",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-20",
        "status": "A",
        "authorized_official_last_name": "HERZOG",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO/MD",
        "authorized_official_telephone_number": "662-335-0183"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "190990002",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9016026",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DA3016",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Delta Health System (Delta Health-Medical Group (Anesthesia))
• Delta Health System (Delta Health-The Medical Center)
• Delta Health System (Delta Health-The Medical Center)
• Delta Health System (Delta Health-The Medical Center)
• Delta Hearing Services
• Delta Kidney Alliance LLC
• Delta Kidney Alliance LLC
• Delta Medical Group
• Delta Pediatric Care
• Delta Pediatric Dental

• Health Service Clinic/Center in Greenville, MS
• Providers in Greenville, MS by specialty
• Health Service Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 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.