Back Clinic, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

BACK CLINIC, LLC

Doing business as

Back Clinic of Mississippi

Practice address

1050 N Flowood Dr
Suite a-1
Flowood, MS 39232-9738

Phone

(601) 936-3515

Fax

(601) 936-0705

NPI assigned

Jan 7, 2008

Last updated

Jan 7, 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

Mrs. Lisa A. Cross

Title

Co-Owner

Phone

(601) 936-3515

Specialties & licenses 1

Addresses

Other names 1

• Back Clinic of Mississippi Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gail Barnett, CFNP

  • Nurse Practitioner
  • Flowood, MS
  • NPI 1477632040
  NPD (past)

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

{
    "created_epoch": "1199664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199664000000",
    "number": "1366627606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 N FLOWOOD DR",
            "address_2": "SUITE A-1",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329738",
            "telephone_number": "601-936-3515",
            "fax_number": "601-936-0705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 N FLOWOOD DR",
            "address_2": "SUITE A-1",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329738",
            "telephone_number": "601-936-3515",
            "fax_number": "601-936-0705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACK CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-07",
        "last_updated": "2008-01-07",
        "status": "A",
        "authorized_official_last_name": "CROSS",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "601-936-3515",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Back Clinic of Mississippi",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Uma Mahesh Reddy Avula, MD
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• Madison Greer Aycock, NP
• Philip A Azordegan, M.D.
• Abdul G Bahro, MD
• Shimeka Lanette Banks, M.D.
• Baptist Medical Clinic - Convenient Care
• Baptist PT - Flowood
• Clifton Barker, OTR/L

• Family Medicine Physician in Flowood, MS
• Providers in Flowood, MS by specialty
• Family Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2008; 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.