Organization Active NPI

Live Oaks Addiction Professionals

  • Addiction Medicine (Family Medicine) Physician
  • Southaven, MS
National Provider Identifier
1619433943
Registry record updated Feb 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X
Legal business name
LIVE OAKS ADDICTION PROFESSIONALS
Practice address
5699 Getwell Rd Ste 1
Southaven, MS 38672-7312
Phone
(662) 510-8400
Fax
(662) 510-8500
NPI assigned
Feb 12, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2019

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

Authorized official

Name
Dr. Gary D. Carr, MDNPI 1093887945
Title
Sole Member
Phone
(662) 510-8400

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
Addiction Medicine (Family Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207QA0401X Primary

Addresses

Primary practice location

5699 Getwell Rd Ste 1
Southaven, MS 38672-7312

Mailing address

201 Methodist Blvd Ste 100
Hattiesburg, MS 39402-1267
Phone (601) 296-3151

National Provider Directory

National Provider Directory

Locations

5699 Getwell Rd
Ste 1
Southaven, MS 38672
Phone (662) 510-8400

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1549929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549929600000",
    "number": "1619433943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 METHODIST BLVD STE 100",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021267",
            "telephone_number": "601-296-3151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5699 GETWELL RD STE 1",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386727312",
            "telephone_number": "662-510-8400",
            "fax_number": "662-510-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVE OAKS ADDICTION PROFESSIONALS",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-12",
        "last_updated": "2019-02-12",
        "status": "A",
        "authorized_official_last_name": "CARR",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "662-510-8400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southaven, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2019; 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.