Madison East Internal Medicine LLC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

MADISON EAST INTERNAL MEDICINE LLC

Practice address

1002 E Madison St
Houston, MS 38851-2417

Phone

(662) 448-6213

Fax

(662) 448-6215

NPI assigned

Apr 10, 2007

Organization subpart

No

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

Authorized official

Name

Noel Villarosa Garcia, MD

Title

Physician

Phone

(662) 448-6213

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257984000000",
    "number": "1295958155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 648",
            "city": "HOUSTON",
            "state": "MS",
            "postal_code": "388510648",
            "telephone_number": "662-448-6213",
            "fax_number": "662-448-6215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 E MADISON ST",
            "city": "HOUSTON",
            "state": "MS",
            "postal_code": "388512417",
            "telephone_number": "662-448-6213",
            "fax_number": "662-448-6215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADISON EAST INTERNAL MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2009-11-12",
        "status": "A",
        "authorized_official_last_name": "GARCIA",
        "authorized_official_first_name": "NOEL",
        "authorized_official_middle_name": "VILLAROSA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "662-448-6213",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00126007",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie O. Hubbard, CFNP
• Levon Kinard
• Christopher W Lancaster, LCSW
• Danny Derek Lantrip, NP
• Lotts of Love
• Amanda Brand Mahan, FNP-C
• MCM of Mississippi LLC
• Med Express of Mississppi
• Mississippi State Department of Health
• Mississippi State Department of Health

• All providers in Houston, MS
• Specialist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2009; 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.