Organization Active NPI

Brian Shwer,DPM

  • Podiatrist
  • Southaven, MS
National Provider Identifier
1508034331
Registry record updated Feb 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
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

Updated by the provider on Feb 1, 2021

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)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 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 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930068201 MS DME Supplier - Physician - Podiatry 9234259433 Practice locations: Southaven, MS

National Provider Directory

National Provider Directory

Locations

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.

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.

Verify at the official NPI Registry.