Organization Active NPI

Mooresville PPM LLC

Doing business as The Center for Surgical Weight Loss

  • Surgery Physician
  • Mooresville, NC
National Provider Identifier
1457621799
Registry record updated Jan 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
MOORESVILLE PPM LLC
Doing business as
The Center for Surgical Weight Loss
Practice address
131 Medical Park Rd
Suite 303
Mooresville, NC 28117-8522
Phone
(704) 660-4584
Fax
(704) 660-4967
NPI assigned
Jan 4, 2012
Last updated
Jan 14, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
MOORESVILLE PPM LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 14, 2022

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

Authorized official

Name
Mrs. Jennifer L Jackson
Title
Sr Dir Prov Enrollment & Onboarding
Phone
(615) 465-3334

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

131 Medical Park Rd
Suite 303
Mooresville, NC 28117-8522

Mailing address

4000 Meridian Blvd
Franklin, TN 37067-6325
Phone (615) 465-7230

Other names 1

  • The Center for Surgical Weight Loss Doing business as

National Provider Directory

National Provider Directory
Part of
Mooresville PPM LLC

NPI Registry JSON

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

{
    "created_epoch": "1325635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642118400000",
    "number": "1457621799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 MERIDIAN BLVD",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370676325",
            "telephone_number": "615-465-7230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 MEDICAL PARK RD",
            "address_2": "SUITE 303",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281178522",
            "telephone_number": "704-660-4584",
            "fax_number": "704-660-4967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOORESVILLE PPM LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MOORESVILLE PPM LLC",
        "enumeration_date": "2012-01-04",
        "last_updated": "2022-01-14",
        "certification_date": "2022-01-14",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SR DIR PROV ENROLLMENT & ONBOARDING",
        "authorized_official_telephone_number": "615-465-3334",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Center for Surgical Weight Loss",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Center for Surgical Weight Loss",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mooresville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2022; 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.