Nuvena Vein Clinic

Primary specialty

Phlebology PhysicianTaxonomy code 202K00000X

License

13236 Issued in MS

Legal business name

NUVENA VEIN CLINIC

Practice address

120 Fountains Blvd
Madison, MS 39110

Phone

(601) 667-4405

Fax

(601) 667-4406

NPI assigned

Apr 26, 2018

Last updated

Apr 26, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Clifford C Adams III, MD

Title

Owner

Phone

(601) 506-3366

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1524700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524700800000",
    "number": "1679061469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 ROSEDOWNE BEND",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "39110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 FOUNTAINS BLVD",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "39110",
            "telephone_number": "601-667-4405",
            "fax_number": "601-667-4406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NUVENA VEIN CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-26",
        "last_updated": "2018-04-26",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "CLIFFORD",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-506-3366",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "202K00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Phlebology",
            "state": "MS",
            "license": "13236",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": "MS",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Phlebology Physician in Madison, MS
• Providers in Madison, MS by specialty
• Phlebology Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2018; 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.