Organization Active NPI

Mississippi Center for Plastic Surgery

  • Plastic and Reconstructive Surgery Physician
  • Ridgeland, MS
National Provider Identifier
1184022485
Registry record updated Oct 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
19109 Issued in MS
Legal business name
MISSISSIPPI CENTER FOR PLASTIC SURGERY
Practice address
200 W Jackson St
Suite 100
Ridgeland, MS 39157-2310
Phone
(769) 300-4055
Fax
(601) 427-5864
NPI assigned
Dec 18, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2015

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

Authorized official

Name
Mrs. Paige C. Swindle
Title
Office Manager
Phone
(769) 300-4055

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0122X 19109 MS Primary

Addresses

Primary practice location

200 W Jackson St
Suite 100
Ridgeland, MS 39157-2310

Mailing address

PO Box 13582
Jackson, MS 39236-3582
Phone (769) 300-4055

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150605001933 MS Part B Supplier - Clinic/Group Practice 6002137775 Receives reassigned benefits from 1 practitioner
Practice locations: Ridgeland, MS

National Provider Directory

National Provider Directory

Locations

150 Jefferson Davis Blvd
Natchez, MS 39120
Phone (601) 446-6634

150 Jefferson Davis Blvd
Ste 110
Natchez, MS 39120
Phone (601) 445-4616

200 W Jackson St
#100
Ridgeland, MS 39157
Phone (601) 543-3659

200 W Jackson St
Ridgeland, MS 39157

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1418860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444262400000",
    "number": "1184022485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13582",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392363582",
            "telephone_number": "769-300-4055",
            "fax_number": "601-427-5864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W JACKSON ST",
            "address_2": "SUITE 100",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391572310",
            "telephone_number": "769-300-4055",
            "fax_number": "601-427-5864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSISSIPPI CENTER FOR PLASTIC SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-18",
        "last_updated": "2015-10-08",
        "status": "A",
        "authorized_official_last_name": "SWINDLE",
        "authorized_official_first_name": "PAIGE",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "769-300-4055",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "MS",
            "license": "19109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgeland, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2015; 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.