Aesthetic Surgery Center LTD

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

11075 Issued in MS

Legal business name

AESTHETIC SURGERY CENTER LTD

Practice address

1720A Medical Park Dr
Suite 140
Biloxi, MS 39532-2129

Phone

(228) 392-4454

Fax

(228) 392-4533

NPI assigned

Jul 19, 2011

Organization subpart

No

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

Authorized official

Name

Courtney Richardson

Title

Vice President

Phone

(228) 392-4454

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Locations

Practitioners 2

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

• Anna Pavlov, MD

  • Plastic and Reconstructive Surgery Physician
  • Gulfport, MS
  • NPI 1821485111

  MS, Plastic Surgery

  Medicare reassignment Care Compare group NPD
• Daniel Quitman Richardson, MD

  • Plastic Surgery Physician
  • Biloxi, MS
  • NPI 1073670758

  MS, Plastic Surgery

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1311033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318982400000",
    "number": "1215225636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6066",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395066066",
            "telephone_number": "228-392-4454",
            "fax_number": "228-392-4533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720A MEDICAL PARK DR",
            "address_2": "SUITE 140",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395322129",
            "telephone_number": "228-392-4454",
            "fax_number": "228-392-4533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AESTHETIC SURGERY CENTER LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-19",
        "last_updated": "2011-10-19",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "COURTNEY",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "228-392-4454"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "MS",
            "license": "11075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adam Abrahms, RRT
• Jordan Abuliel, PHARMD, RPH
• Dorothy Denise Adams, NP
• Stephanie Lynn Addison, NP
• Moses Oyegoke Adedeji, MD
• Ahmad Agha, M.B.B.S.
• Seren Emerson Ainsworth II, FNP-C
• Adam Derrick Akers, PSY.D.
• Kole Prasad Akula, MD
• Belinda Alexander, M.D.

• All providers in Biloxi, MS
• Plastic Surgery Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2011; 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.