Elements Medical Group of Mississippi Inc

Primary specialty

Addiction Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0401X

License

7875 Issued in MS

Legal business name

ELEMENTS MEDICAL GROUP OF MISSISSIPPI INC

Practice address

3949 Highway 43 N
Brandon, MS 39047-7240

Phone

(601) 829-2500

Fax

(601) 829-4278

NPI assigned

Jun 21, 2017

Last updated

Jun 21, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Cheryl Maplesden

Title

Sr Director RCM

Phone

(615) 540-3708

Specialties & licenses 4

Addresses

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

{
    "created_epoch": "1498003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498003200000",
    "number": "1508386582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 671673",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752671673",
            "telephone_number": "562-303-9718",
            "fax_number": "562-264-1219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3949 HIGHWAY 43 N",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390477240",
            "telephone_number": "601-829-2500",
            "fax_number": "601-829-4278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELEMENTS MEDICAL GROUP OF MISSISSIPPI INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-21",
        "last_updated": "2017-06-21",
        "status": "A",
        "authorized_official_last_name": "MAPLESDEN",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_title_or_position": "SR DIRECTOR RCM",
        "authorized_official_telephone_number": "615-540-3708"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "862194",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MS",
            "license": "850823",
            "primary": false
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "MS",
            "license": "7875",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MS",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Addiction Medicine (Internal Medicine) Physician in Brandon, MS
• Providers in Brandon, MS by specialty
• Addiction Medicine (Internal Medicine) Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2017; 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.