Organization Active NPI

TRM Endovascular & Wound Care Services LLC

  • Vascular & Interventional Radiology Physician
  • Southaven, MS
National Provider Identifier
1629800412
Registry record updated Nov 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
Legal business name
TRM ENDOVASCULAR & WOUND CARE SERVICES LLC
Practice address
7900 Airways Blvd Ste 6
Southaven, MS 38671-4113
Phone
(662) 470-7554
Fax
(269) 906-2006
NPI assigned
Aug 19, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2025

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

Authorized official

Name
David Barham
Title
President
Phone
(662) 470-7554

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0204X Primary

Addresses

Primary practice location

7900 Airways Blvd Ste 6
Southaven, MS 38671-4113

Mailing address

7900 Airways Blvd Ste 6
Southaven, MS 38671-4113
Phone (662) 470-7554

Other practice location 1

2200 Union Ave
Memphis, TN 38104-4205
Phone (662) 470-7554

Other identifiers 1

IdentifierTypeStateIssuer
26915OtherMSSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, TN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20250421000046 MS Part B Supplier - Clinic/Group Practice 4183159163 Receives reassigned benefits from 6 practitioners
Practice locations: Batesville, MS; Oxford, MS; Southaven, MS
O20251105001923 TN Part B Supplier - Clinic/Group Practice 4183159163 Receives reassigned benefits from 2 practitioners
Practice locations: Memphis, TN

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
25D2310987TRM Endovascular and Wound Care Services PLLC7900 Airways Blvd Suite 5, Southaven, MS 38671Certificate of waiverSep 12, 2026

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

7900 Airways Blvd
Ste 6
Southaven, MS 38671
Phone (662) 470-7554

Practitioners & affiliated clinicians

Practitioners 7

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": "1724025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762128000000",
    "number": "1629800412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7900 AIRWAYS BLVD STE 6",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386714113",
            "telephone_number": "662-470-7554",
            "fax_number": "269-906-2006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7900 AIRWAYS BLVD STE 6",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386714113",
            "telephone_number": "662-470-7554",
            "fax_number": "269-906-2006"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2200 Union Ave",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381044205",
            "country_code": "US",
            "telephone_number": "662-470-7554",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TRM ENDOVASCULAR & WOUND CARE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-19",
        "last_updated": "2025-11-03",
        "certification_date": "2025-11-03",
        "status": "A",
        "authorized_official_last_name": "BARHAM",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "662-470-7554"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "26915",
            "state": "MS"
        }
    ],
    "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 Nov 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.