Midsouth Vision Service

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

MIDSOUTH VISION SERVICE

Practice address

8 County Road 197
Iuka, MS 38852-8148

Phone

(662) 423-7619

Fax

(662) 423-2849

NPI assigned

Feb 2, 2023

Organization subpart

No

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

Authorized official

Name

Phillip Adam Gray, ODNPI 1518980051

Title

Owner/Optometrist

Phone

(662) 423-7619

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Phillip Adam Gray, O. D.

  • Optometrist
  • Iuka, MS
  • NPI 1518980051
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1675296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678060800000",
    "number": "1407552219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 COUNTY ROAD 197",
            "city": "IUKA",
            "state": "MS",
            "postal_code": "388528148",
            "telephone_number": "662-423-7619",
            "fax_number": "662-423-2849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 COUNTY ROAD 197",
            "city": "IUKA",
            "state": "MS",
            "postal_code": "388528148",
            "telephone_number": "662-423-7619",
            "fax_number": "662-423-2849"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "105 S Fulton St",
            "address_purpose": "LOCATION",
            "city": "Iuka",
            "state": "MS",
            "postal_code": "388522328",
            "country_code": "US",
            "telephone_number": "662-423-3785",
            "fax_number": "662-423-2849",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MIDSOUTH VISION SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-02",
        "last_updated": "2023-03-06",
        "certification_date": "2023-03-06",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "ADAM",
        "authorized_official_title_or_position": "OWNER/OPTOMETRIST",
        "authorized_official_telephone_number": "662-423-7619",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brenton McKay, FNP
• Molly McLain, MSN, APRN, PMHNP-BC
• Brianna Meador
• Medicomp, Inc (Medicomp Physical Therapy Iuka)
• Braxton Kye Meeks, FNP
• Mineral Springs Health Care,PLLC
• Mississippi State Department of Health
• Rhonda Vaught Mitchell
• Lisa Mooney, ST
• Amy H Moore, ST

• Optometrist in Iuka, MS
• Providers in Iuka, MS by specialty
• Optometrist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2023; 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.