Plastic Surgical Center of Mississippi

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

PLASTIC SURGICAL CENTER OF MISSISSIPPI

Practice address

2550 Flowood Dr Ste 101
Flowood, MS 39232-9304

Phone

(601) 939-5544

Fax

(601) 939-8874

NPI assigned

Nov 7, 2005

Organization subpart

No

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

Authorized official

Name

Mrs. Tammy Burnett

Title

Chief Executive Officer

Phone

(601) 939-9999

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Listed as

Plastic Surgical Center of MississippiCCN 25C0001045

Medicare certification status

ActiveFrom the Provider of Services file

Locations

Practitioners 1

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

• Eric E Wegener, M.D.

  • Surgery of the Hand (Plastic Surgery) Physician
  • Flowood, MS
  • NPI 1578592226
  NPD (past)

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

{
    "created_epoch": "1131321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288224000000",
    "number": "1508847690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 FLOWOOD DR STE 101",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329304",
            "telephone_number": "601-939-5544",
            "fax_number": "601-939-8874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 FLOWOOD DR STE 101",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329304",
            "telephone_number": "601-939-5544",
            "fax_number": "601-939-8874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLASTIC SURGICAL CENTER OF MISSISSIPPI",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-07",
        "last_updated": "2010-10-28",
        "status": "A",
        "authorized_official_last_name": "BURNETT",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "601-939-9999",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0734275",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura Russell Pitre, LPC
• Rava Pittman, FNP-BC
• Clayton Lowery Pitts, D.C.
• Plastic & Hand Surgery Associates PLLC
• Plastic Surgery Associates of Ms
• Noah Pogue, RN
• Jason Polk
• Shelby B Polk, DNP, APRN, FNP-BC
• Jamye Pollard, DNP, CRNA
• Mary Claire Ponder, APRN

• Ambulatory Surgical Clinic/Center in Flowood, MS
• Providers in Flowood, MS by specialty
• Ambulatory Surgical Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.