Active NPI
NW Mississippi Specialty Clinic
- Radiation Oncology Physician
- Greenwood, MS
National Provider Identifier
1548424914
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiation Oncology Physician
- License
- 14914
- Legal business name
- NW MISSISSIPPI SPECIALTY CLINIC
- Practice address
- 1401 River Rd
Greenwood, MS 38930-4030 - Phone
- (888) 670-6080
- Fax
- (770) 443-4410
- NPI assigned
- Jul 15, 2008
- Last updated
- Jul 15, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Roderick Givens, MD
- Title
- President
- Phone
- (770) 443-4483
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiation Oncology Physician | 2085R0001X | 14914 | MS | Primary |
Addresses
Primary practice location
1401 River Rd
Greenwood, MS 38930-4030
Mailing address
PO Box 18394
Natchez, MS 39122-8394
Phone (888) 670-6080
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00117509 | Medicaid | MS |
Other names 1
- Southern Healthcare Providers PA
National Provider Directory
National Provider Directory- Tax ID family
- N W Mississippi Specialty Clinic
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
dba N W Mississippi Specialty Clinic
- Ph.D. Medical Genetics
- Greenwood, MS
- NPI 1568660744
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1216080000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1216080000000",
"number": "1548424914",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 18394",
"city": "NATCHEZ",
"state": "MS",
"postal_code": "391228394",
"telephone_number": "888-670-6080",
"fax_number": "770-443-4410"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1401 RIVER RD",
"city": "GREENWOOD",
"state": "MS",
"postal_code": "389304030",
"telephone_number": "888-670-6080",
"fax_number": "770-443-4410"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NW MISSISSIPPI SPECIALTY CLINIC",
"organizational_subpart": "NO",
"enumeration_date": "2008-07-15",
"last_updated": "2008-07-15",
"status": "A",
"authorized_official_last_name": "GIVENS",
"authorized_official_first_name": "RODERICK",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "770-443-4483",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "2085R0001X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Radiology, Radiation Oncology",
"state": "MS",
"license": "14914",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00117509",
"state": "MS"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Southern Healthcare Providers PA",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Greenwood, MS
- North Florida Radiological Institute Inc
- North Sunflower Medical Center (Sunflower Greenwood Clinic)
- North Sunflower Medical Center (Sunflower Greenwood Clinic)
- North Sunflower Medical Center (Sunflower Greenwood Pharmacy)
- North Sunflower Medical Center (Sunflower Greenwood Medical Equipment)
- Elizabeth A. O'Brien, OTR/L
- Robert E. O'Brien, R.P.T.
- Fortune Ojeah
- Optimum Occupational Therapy Services, LLC
- Janice Outlaw, LPM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.