Silver Medical Associates, LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

1095115 Issued in MS

Legal business name

SILVER MEDICAL ASSOCIATES, LLC

Practice address

814 S Haugh Ave
Box 1675
Picayune, MS 39466-5350

Phone

(769) 242-2020

Fax

(769) 242-2023

NPI assigned

Sep 1, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Kim Antoinette Mitchell-Silver, M.D.

Title

Owner/Administrator

Phone

(769) 242-2020

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1396291944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "814 S HAUGH AVE",
            "city": "PICAYUNE",
            "state": "MS",
            "postal_code": "394665350",
            "telephone_number": "769-242-2020",
            "fax_number": "769-242-2023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "814 S HAUGH AVE",
            "address_2": "BOX 1675",
            "city": "PICAYUNE",
            "state": "MS",
            "postal_code": "394665350",
            "telephone_number": "769-242-2020",
            "fax_number": "769-242-2023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SILVER MEDICAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-01",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "MITCHELL-SILVER",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "ANTOINETTE",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "769-242-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MS",
            "license": "1095115",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02274570",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00606725",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emily Seal, LMSW
• Darlene Seals
• Clide S Sherrod, MD
• Eric Todd Siegel, M.D.
• Kendal Blaine Silve, PHARM D
• Rhonda Simmons, LCSW
• Elizabeth Ann Skipper, LCSW
• Daniel Zane Slade
• Karly Mitchell Slade, COTA/L
• Shannon Elaine Slizoski, LMFT

• Clinic/Center in Picayune, MS
• Providers in Picayune, MS by specialty
• Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.