Organization Active NPI

Flowood Medical Management LLC

  • Vascular Surgery Physician
  • Flowood, MS
National Provider Identifier
1457714172
Registry record updated Mar 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
FLOWOOD MEDICAL MANAGEMENT LLC
Practice address
4800 Lakeland Dr
Flowood, MS 39232-8694
Phone
(601) 953-5256
NPI assigned
Mar 30, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2016

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

Authorized official

Name
Shane Tapper
Title
Owner
Phone
(601) 953-5256

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0129X Primary

Addresses

Primary practice location

4800 Lakeland Dr
Flowood, MS 39232-8694

Mailing address

111 Belle Meade PT Ste B
Flowood, MS 39232-3337

Other names 1

  • Evexia Vein Center Doing business as

National Provider Directory

National Provider Directory

Locations

111 Belle Meade Pt
Ste B
Flowood, MS 39232

NPI Registry JSON

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

{
    "created_epoch": "1459296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459296000000",
    "number": "1457714172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 BELLE MEADE PT STE B",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392323337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 LAKELAND DR",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392328694",
            "telephone_number": "601-953-5256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLOWOOD MEDICAL MANAGEMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-30",
        "last_updated": "2016-03-30",
        "status": "A",
        "authorized_official_last_name": "TAPPER",
        "authorized_official_first_name": "SHANE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-953-5256"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evexia Vein Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Flowood, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2016; 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.