S&K Medical,LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

S&K MEDICAL,LLC

Doing business as

Superior Health and Wellness

Practice address

2085 Goodman Rd W
Horn Lake, MS 38637-1416

Phone

(662) 253-8459

Fax

(662) 253-8678

NPI assigned

Jan 16, 2015

Last updated

Sep 14, 2016By 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

Diane Ferguson, MDNPI 1265525331

Title

Owner

Phone

(601) 942-6902

Specialties & licenses 1

Addresses

Other names 1

• Superior Health and Wellness Doing business as

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Locations

Practitioners 2

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.

• Diane A Ferguson, MD

  • Family Medicine Physician
  • Horn Lake, MS
  • NPI 1265525331
  Medicare reassignment Care Compare group NPD Authorized official
• Lanissa Danielle Odor, FNP-BC

  • Family Nurse Practitioner
  • Horn Lake, MS
  • NPI 1083056386
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1421366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473811200000",
    "number": "1396134151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5885 AIRLINE RD UNIT 962",
            "city": "ARLINGTON",
            "state": "TN",
            "postal_code": "380025121",
            "telephone_number": "901-317-7427",
            "fax_number": "901-317-7585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2085 GOODMAN RD W",
            "city": "HORN LAKE",
            "state": "MS",
            "postal_code": "386371416",
            "telephone_number": "662-253-8459",
            "fax_number": "662-253-8678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S&K MEDICAL,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-16",
        "last_updated": "2016-09-14",
        "status": "A",
        "authorized_official_last_name": "FERGUSON",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-942-6902",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Superior Health and Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tiffany Shannon Ray, CRNA
• Katherine Reece, DDS
• Brian Darrel Rhoads, DDS
• Arthur Thomas Roach, P.A.-C.
• Jacqueline Rueda, PT.
• Salve Family Health PC
• Achin Sharma, M.D.
• Jessica White Sims, PHARMD
• Kathryn Derivaux Smith, D.D.S.
• Kaila Stepter, CNA

• Family Medicine Physician in Horn Lake, MS
• Providers in Horn Lake, 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 Sep 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.