NPIMap

Organization Active NPI

Addiction Campuses Professional Services of Mississippi, LLC

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Southaven, MS
National Provider Identifier
1659990075
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084A0401X
Legal business name
ADDICTION CAMPUSES PROFESSIONAL SERVICES OF MISSISSIPPI, LLC
Practice address
340 Stateline Rd W
Southaven, MS 38671-1610
Phone
(662) 510-5387
Fax
(662) 342-0782
NPI assigned
Apr 15, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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

Authorized official

Name
Steve Armond
Title
Cfo
Phone
(615) 921-4475

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Psychiatry & Neurology) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084A0401X Primary

Addresses

Primary practice location

340 Stateline Rd W
Southaven, MS 38671-1610

Mailing address

205 Reidhurst Ave
Nashville, TN 37203-1618

National Provider Directory

National Provider Directory

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": "1586908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693958400000",
    "number": "1659990075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 REIDHURST AVE",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372031618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 STATELINE RD W",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386711610",
            "telephone_number": "662-510-5387",
            "fax_number": "662-342-0782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADDICTION CAMPUSES PROFESSIONAL SERVICES OF MISSISSIPPI, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-15",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A",
        "authorized_official_last_name": "ARMOND",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "615-921-4475"
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, 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 Sep 6, 2023; 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.