Organization Active NPI

Sharkey-Issaquena Adult Daycare

  • Adult Development & Aging Psychologist
  • Greenville, MS
National Provider Identifier
1174953525
Registry record updated Nov 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Development & Aging PsychologistTaxonomy code 103TA0700X
License
103TA0700X Issued in MS
Legal business name
SHARKEY-ISSAQUENA ADULT DAYCARE
Practice address
449 Oakland Drive
Greenville, MS 38701
Phone
(832) 315-9741
NPI assigned
Nov 21, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2013

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

Authorized official

Name
Mark Crawford
Title
Chief Executive Officer
Phone
(832) 315-9741

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Development & Aging PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TA0700X 103TA0700X MS Primary

Addresses

Primary practice location

449 Oakland Drive
Greenville, MS 38701

Mailing address

449 Oakland Drive
Greenville, MS 38701
Phone (832) 315-9741

Other names 1

  • MS Investments LTD Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1384992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384992000000",
    "number": "1174953525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "449 OAKLAND DRIVE",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "38701",
            "telephone_number": "832-315-9741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "449 OAKLAND DRIVE",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "38701",
            "telephone_number": "832-315-9741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHARKEY-ISSAQUENA ADULT DAYCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-21",
        "last_updated": "2013-11-21",
        "status": "A",
        "authorized_official_last_name": "CRAWFORD",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "832-315-9741"
    },
    "taxonomies": [
        {
            "code": "103TA0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "MS",
            "license": "103TA0700X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MS Investments LTD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greenville, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2013; 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.