Mississippi Surgical Specialties Center PA

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

03952 Issued in MS

Legal business name

MISSISSIPPI SURGICAL SPECIALTIES CENTER PA

Practice address

1401 River Road
Greenwood, MS 38930-1410

Phone

(662) 453-9305

Fax

(662) 451-5157

NPI assigned

Jan 31, 2006

Organization subpart

No

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

Authorized official

Name

Annie Smith, CCS-P, CCA

Title

Supervisor

Phone

(662) 453-9305

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1138665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278633600000",
    "number": "1346211976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10117",
            "city": "GREENWOOD",
            "state": "MS",
            "postal_code": "389300117",
            "telephone_number": "662-453-9305",
            "fax_number": "662-451-5157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 RIVER ROAD",
            "city": "GREENWOOD",
            "state": "MS",
            "postal_code": "389301410",
            "telephone_number": "662-453-9305",
            "fax_number": "662-451-5157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSISSIPPI SURGICAL SPECIALTIES CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-31",
        "last_updated": "2010-07-09",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "ANNIE",
        "authorized_official_title_or_position": "SUPERVISOR",
        "authorized_official_telephone_number": "662-453-9305",
        "authorized_official_credential": "CCS-P, CCA"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "MS",
            "license": "03952",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00018589",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lashundra Miller
• Diana Mims
• Mississippi CVS Pharmacy, L.L.C.
• Mississippi Diversified Healthcare
• Mississippi State Department of Health
• India Alexander Mitchell
• Penny Mitchell
• Antoinette Parks Montgomery, PCMHT
• Moore Tranport Services MTS LLC
• Frederick Earl Moore Jr.

• Surgery Physician in Greenwood, MS
• Providers in Greenwood, MS by specialty
• Surgery Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2010; 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.