Southern Healthcare Providers

Primary specialty

Ph.D. Medical GeneticsTaxonomy code 170100000X

License

14914 Issued in MS

Legal business name

SOUTHERN HEALTHCARE PROVIDERS

Practice address

1401 River Rd
Greenwood, MS 38930-4030

Phone

(770) 429-1411

Fax

(770) 429-1951

NPI assigned

Jul 10, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Roderick C Givens, M.D.

Title

President

Phone

(770) 429-1411

Specialties & licenses 1

Addresses

Other names 1

• N W MISSISSIPPI SPECIALTY CLINIC Doing business as

Tax ID family

N W Mississippi Specialty Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• NW Mississippi Specialty Clinic

  • Radiation Oncology Physician
  • Greenwood, MS
  • NPI 1548424914
  NPD tax ID

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

{
    "created_epoch": "1184025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184025600000",
    "number": "1568660744",
    "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": "770-429-1411",
            "fax_number": "770-429-1951"
        },
        {
            "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": "770-429-1411",
            "fax_number": "770-429-1951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN HEALTHCARE PROVIDERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-10",
        "last_updated": "2007-07-10",
        "status": "A",
        "authorized_official_last_name": "GIVENS",
        "authorized_official_first_name": "RODERICK",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-429-1411",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "170100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Medical Genetics, Ph.D. Medical Genetics",
            "state": "MS",
            "license": "14914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "N W MISSISSIPPI SPECIALTY CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Laporsha Danette Smith, PHARMD
• Lisa Stuart Smith, PHARM.D.
• Ralph Arnold Smith Jr., M.D.
• Susan Noelle Smith, DPT
• Taquila Smith
• Paula J Spence-Evans, M.D.
• Mickaeya Spencer
• Stacey D Sprayberry, FNP
• Linda Sprouse
• Sta-Home Health Agency of Greenwood, Inc.

• Ph.D. Medical Genetics in Greenwood, MS
• Providers in Greenwood, MS by specialty
• Ph.D. Medical Genetics in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2007; 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.