NPIMap

Organization Active NPI

Vibha Vig MD PA

  • Primary Care Clinic/Center
  • Canton, MS
National Provider Identifier
1255413639
Registry record updated Mar 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
13655 Issued in MS
Legal business name
VIBHA VIG MD PA
Practice address
156 River Oaks Dr
Suite a
Canton, MS 39046-5376
Phone
(601) 855-5287
Fax
(601) 855-5130
NPI assigned
Oct 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2013

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

Authorized official

Name
Vibha Vig, MDNPI 1689619405
Title
Owner
Phone
(601) 855-5287

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 13655 MS Primary

Addresses

Primary practice location

156 River Oaks Dr
Suite a
Canton, MS 39046-5376

Mailing address

PO Box 626
Canton, MS 39046-0626
Phone (601) 855-5287

Other identifiers 1

IdentifierTypeStateIssuer
09015814MedicaidMS

Other names 1

  • Sunshine Medical Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Vibha Vig MD PA3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

156 River Oaks Dr
#A
Canton, MS 39046
Phone (601) 855-5287

Practitioners & affiliated clinicians

Practitioners 6

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": "1161216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363305600000",
    "number": "1255413639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 626",
            "city": "CANTON",
            "state": "MS",
            "postal_code": "390460626",
            "telephone_number": "601-855-5287",
            "fax_number": "601-855-5130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "156 RIVER OAKS DR",
            "address_2": "SUITE A",
            "city": "CANTON",
            "state": "MS",
            "postal_code": "390465376",
            "telephone_number": "601-855-5287",
            "fax_number": "601-855-5130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIBHA VIG MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-19",
        "last_updated": "2013-03-15",
        "status": "A",
        "authorized_official_last_name": "VIG",
        "authorized_official_first_name": "VIBHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-855-5287",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MS",
            "license": "13655",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09015814",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sunshine Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Canton, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 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.