NPIMap

Organization Active NPI

Electrodiagnostic Consultants, PLLC

  • Neurology Physician
  • Jackson, MS
National Provider Identifier
1568583524
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
13667 Issued in MS
Legal business name
ELECTRODIAGNOSTIC CONSULTANTS, PLLC
Practice address
1350 E Woodrow Wilson Ave
Suite 2
Jackson, MS 39216-5112
Phone
(601) 981-1234
Fax
(601) 981-3989
NPI assigned
Apr 3, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Angel Arturo Leis, MDNPI 1841302411
Title
Owner
Phone
(601) 981-1234

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 13667 MS Primary

Addresses

Primary practice location

1350 E Woodrow Wilson Ave
Suite 2
Jackson, MS 39216-5112

Mailing address

1350 E Woodrow Wilson Ave
Suite 2
Jackson, MS 39216-5112
Phone (601) 981-1234

Other identifiers 1

IdentifierTypeStateIssuer
09015353MedicaidMS

National Provider Directory

National Provider Directory

Locations

1350 E Woodrow Wilson Ave
#A
Jackson, MS 39216
Phone (601) 981-1234

1350 E Woodrow Wilson Ave
Ste 2
Jackson, MS 39216
Phone (601) 981-1234

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1568583524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 E WOODROW WILSON AVE",
            "address_2": "SUITE 2",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392165112",
            "telephone_number": "601-981-1234",
            "fax_number": "601-981-3989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 E WOODROW WILSON AVE",
            "address_2": "SUITE 2",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392165112",
            "telephone_number": "601-981-1234",
            "fax_number": "601-981-3989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELECTRODIAGNOSTIC CONSULTANTS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LEIS",
        "authorized_official_first_name": "ANGEL",
        "authorized_official_middle_name": "ARTURO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-981-1234",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MS",
            "license": "13667",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09015353",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.