Mississippi Lactation Services

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

9307 Issued in MS

Legal business name

MISSISSIPPI LACTATION SERVICES

Practice address

435 Katherine Dr Ste B
Flowood, MS 39232-9781

Phone

(601) 932-6455

NPI assigned

May 1, 2015

Last updated

May 1, 2015By 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

Mr. Michael Austin Puckett

Title

Co-Founder

Phone

(601) 932-6455

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mary Christina Glick, M.D.

  • Neonatal-Perinatal Medicine Physician
  • Flowood, MS
  • NPI 1457450058
  NPD (past)

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

{
    "created_epoch": "1430438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430438400000",
    "number": "1538546247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 321412",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392321412",
            "telephone_number": "601-932-6455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 KATHERINE DR STE B",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329781",
            "telephone_number": "601-932-6455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSISSIPPI LACTATION SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-01",
        "last_updated": "2015-05-01",
        "status": "A",
        "authorized_official_last_name": "PUCKETT",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "AUSTIN",
        "authorized_official_title_or_position": "CO-FOUNDER",
        "authorized_official_telephone_number": "601-932-6455",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MS",
            "license": "9307",
            "primary": true
        },
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0014803",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mississippi Hma Hospitalists, LLC (River Oaks Hospital)
• Mississippi Medical Relief Care Services
• Mississippi Medical Specialists PC
• Mississippi Methodist Hospital Rehabilitation Center Inc (Methodist Rehab Center)
• Mississippi Neurology Center, PA
• Mississippi Neurosurgery and Spine Center,PLLC

• Pediatrics Physician in Flowood, MS
• Providers in Flowood, MS by specialty
• Pediatrics Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2015; 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.