Mid-South Gastroenterology Group, Inc.

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

0000000101 Issued in TN

Legal business name

MID-SOUTH GASTROENTEROLOGY GROUP, INC.

Practice address

1417 Monroe Ave
Memphis, TN 38104-3634

Phone

(901) 272-7200

Fax

(901) 260-5916

NPI assigned

Aug 22, 2006

Last updated

Nov 19, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Seandria F Echols

Title

Director of Operations

Phone

(901) 272-7200

Specialties & licenses 1

Addresses

Other identifiers 1

Listed as

Midsouth Gastroenterology Group IncCCN 44C0001081

Medicare certification status

ActiveFrom the Provider of Services file

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Bowden Gastro Associates LLC

  • Ambulatory Surgical Clinic/Center
  • Memphis, TN
  • NPI 1952820037

  Member Of

  NPD member

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1227052800000",
    "number": "1275649063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1417 MONROE AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381043634",
            "telephone_number": "901-272-7200",
            "fax_number": "901-260-5916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1417 MONROE AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381043634",
            "telephone_number": "901-272-7200",
            "fax_number": "901-260-5916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-SOUTH GASTROENTEROLOGY GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-22",
        "last_updated": "2008-11-19",
        "status": "A",
        "authorized_official_last_name": "ECHOLS",
        "authorized_official_first_name": "SEANDRIA",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "901-272-7200",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "TN",
            "license": "0000000101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3287965",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mid-South Area Residential Services
• Mid-South Cardiovascular Center, LLC
• Mid-South Education and Behavior Solutions, LLC
• Mid-South Foot and Ankle Specialists, PLLC
• Mid-South Foot and Ankle Specialists, PLLC
• Mid-South Geriatrics & Palliative Care PLLC
• Mid-South Health Services, LLC (Ashton Place Health & Rehab Center)
• Mid-South Healthnet
• Mid-South Home Health Services, LLC (BrightStar Care of Memphis)
• Mid-South Home Health, LLC (Acti-Kare Responsive In-Home Care)

• Ambulatory Surgical Clinic/Center in Memphis, TN
• Providers in Memphis, TN by specialty
• Ambulatory Surgical Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.