Active NPI
Brian Shwer,DPM
- Podiatrist
- Southaven, MS
National Provider Identifier
1508034331
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- Legal business name
- BRIAN SHWER,DPM
- Practice address
- 564 Goodman Rd E
Southaven, MS 38671-9526 - Phone
- (662) 349-7333
- Fax
- (662) 349-0550
- NPI assigned
- Feb 14, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Brian I Shwer, DPM
- Title
- Owner
- Phone
- (662) 349-7333
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | TN | Primary | |
| Durable Medical Equipment & Medical Supplies | 332B00000X | DPM458 | TN |
Addresses
Primary practice location
564 Goodman Rd E
Southaven, MS 38671-9526
Mailing address
564 Goodman Rd E
Southaven, MS 38671-9526
Phone (662) 349-7333
Other names 1
- Southaven Foot Clinic
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MS
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930068201 | MS | DME Supplier - Physician - Podiatry | 9234259433 | Practice locations: Southaven, MS |
National Provider Directory
National Provider DirectoryLocations
564 Goodman Rd E
Southaven, MS 38671
Phone (662) 349-1959
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Psychologist
- Bartlett, TN
- NPI 1164978268
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1202947200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1612137600000",
"number": "1508034331",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "564 GOODMAN RD E",
"city": "SOUTHAVEN",
"state": "MS",
"postal_code": "386719526",
"telephone_number": "662-349-7333",
"fax_number": "662-349-0550"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "564 GOODMAN RD E",
"city": "SOUTHAVEN",
"state": "MS",
"postal_code": "386719526",
"telephone_number": "662-349-7333",
"fax_number": "662-349-0550"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BRIAN SHWER,DPM",
"organizational_subpart": "NO",
"enumeration_date": "2008-02-14",
"last_updated": "2021-02-01",
"certification_date": "2021-02-01",
"status": "A",
"authorized_official_last_name": "SHWER",
"authorized_official_first_name": "BRIAN",
"authorized_official_middle_name": "I",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "662-349-7333",
"authorized_official_credential": "DPM"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Podiatrist",
"state": "TN",
"license": null,
"primary": true
},
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "TN",
"license": "DPM458",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Southaven Foot Clinic",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Southaven Foot Clinic",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Southaven, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2021; 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.