Momentum Medical Services, LLC

Primary specialty

Surgical AssistantTaxonomy code 246ZC0007X

Legal business name

MOMENTUM MEDICAL SERVICES, LLC

Practice address

400 Wainwright St
Waveland, MS 39576-2511

Phone

(228) 263-0037

Fax

(228) 466-4925

NPI assigned

Jul 25, 2013

Organization subpart

No

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

Authorized official

Name

Mr. Orton F Grinnell II, CSFA/CST

Title

President

Phone

(228) 263-0037

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1374710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374710400000",
    "number": "1265874648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 WAINWRIGHT ST",
            "city": "WAVELAND",
            "state": "MS",
            "postal_code": "395762511",
            "telephone_number": "228-263-0037",
            "fax_number": "228-466-4925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 WAINWRIGHT ST",
            "city": "WAVELAND",
            "state": "MS",
            "postal_code": "395762511",
            "telephone_number": "228-263-0037",
            "fax_number": "228-466-4925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOMENTUM MEDICAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-25",
        "last_updated": "2013-07-25",
        "status": "A",
        "authorized_official_last_name": "GRINNELL",
        "authorized_official_first_name": "ORTON",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "228-263-0037",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "CSFA/CST"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSFA CERTIFICATE NUMBER",
            "identifier": "115739",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kellie A Lutz, PHARM D
• Amy Ruth Lynch, M.A.
• Rachelle Ann Magee
• Tiffany Anne Mazzoli
• Lamonice Marie McCullom, NP
• Thomas Beatty Murphree Jr., D.D.S.
• Annie Thi Nguyen
• Khanh Nguyen
• Thanh N Nguyen
• Tram H Nguyen, PHARM.D.

• All providers in Waveland, MS
• Surgical Assistant in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 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.