Baptist Desoto Surgery Center, LP

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

BAPTIST DESOTO SURGERY CENTER, LP

Practice address

391 Southcrest Circle
Suite 100
Southaven, MS 38671-4775

Phone

(662) 349-0910

Fax

(662) 349-0911

NPI assigned

Feb 22, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Angela Ferrell, R.N.

Title

Administrator

Phone

(662) 349-0910

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Listed as

Desoto Surgery CenterCCN 25C0001056

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Baptist Memorial Hospital-Desoto, Inc,

  • General Acute Care Hospital
  • Southaven, MS
  • NPI 1194789818

  Member Of

  NPD member

Locations

Practitioners 1

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

• Alan R Schaeffer, MD

  • Ophthalmology Physician
  • Southaven, MS
  • NPI 1912937574
  NPD (past)

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

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292803200000",
    "number": "1447225503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "391 SOUTHCREST CIRCLE",
            "address_2": "SUITE 100",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386714775",
            "telephone_number": "662-349-0910",
            "fax_number": "662-349-0911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "391 SOUTHCREST CIRCLE",
            "address_2": "SUITE 100",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386714775",
            "telephone_number": "662-349-0910",
            "fax_number": "662-349-0911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAPTIST DESOTO SURGERY CENTER, LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-22",
        "last_updated": "2010-12-20",
        "status": "A",
        "authorized_official_last_name": "FERRELL",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "662-349-0910",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MS",
            "license": "026",
            "primary": false
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00239288",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Renita Marie Baldon
• Patrick Andrew Ball, DO
• Thomas Kelly Ballard IV
• Erica R Balthrop, MD
• Mallareddy Banala, MD
• Baptist Memorial Hospital Desoto
• Baptist Memorial Hospital- Desoto
• Baptist Memorial Hospital-Desoto, Inc,
• Baptist Memorial Hospital-Desoto, Inc.
• Baptist Memorial Hospital-Desoto, Inc.

• Ambulatory Surgical Clinic/Center in Southaven, MS
• Providers in Southaven, MS by specialty
• Ambulatory Surgical Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.