Mississippi Center for Advanced Medicine, PC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

MISSISSIPPI CENTER FOR ADVANCED MEDICINE, PC

Doing business as

Louisiana Center for Advanced Medicine

Practice address

2053 Gause Blvd E Ste 200
Slidell, LA 70461-5451

Phone

(985) 259-8045

Fax

(601) 499-0936

NPI assigned

Jun 18, 2019

Organization subpart

Yes

Parent organization

MISSISSIPPI CENTER FOR ADVANCED MEDICINE, PCAs reported in NPPES

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

Authorized official

Name

Spencer K Sullivan

Title

Ceo/Owner

Phone

(601) 499-0935

Specialties & licenses 1

Addresses

Other names 1

• Louisiana Center for Advanced Medicine Doing business as

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Mississippi Center for Advanced Medicine, PC

  • Specialist
  • Madison, MS
  • NPI 1790227627

  1951693282

  Same PAC ID

Part of

Mississippi Ctr for Adv Med

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tammuella Evelyn Chrisentery-Singleton, MD

  • Pediatric Hematology & Oncology Physician
  • New Orleans, LA
  • NPI 1710900758
  Medicare reassignment NPD

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

{
    "created_epoch": "1560816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560816000000",
    "number": "1508426917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7731 OLD CANTON RD STE B",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391106115",
            "telephone_number": "601-499-0935",
            "fax_number": "601-499-0936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2053 GAUSE BLVD E STE 200",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704615451",
            "telephone_number": "985-259-8045",
            "fax_number": "601-499-0936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSISSIPPI CENTER FOR ADVANCED MEDICINE, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MISSISSIPPI CENTER FOR ADVANCED MEDICINE, PC",
        "enumeration_date": "2019-06-18",
        "last_updated": "2019-06-18",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "SPENCER",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "601-499-0935"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Louisiana Center for Advanced Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michael Millet
• Lisa Milliet, M.S., PLPC
• Joshua Mills, MHS
• Mind and Body Care LLC
• Mind Changing Inc
• Mississippi Center for Advanced Medicine, PC (Louisiana Center for Advanced Medicine)
• Shelley Mitchell, RN
• Tara Mitchell, MD
• Taylor Mobley, MA, PLPC
• James Patrick Mollere, CRNA

• Specialist in Slidell, LA
• Providers in Slidell, LA by specialty
• Specialist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2019; 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.