Active NPI
Flowood Vascular Access ASC LLC
- Ambulatory Surgical Clinic/Center
- Flowood, MS
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Surgical Clinic/Center
- Legal business name
- FLOWOOD VASCULAR ACCESS ASC LLC
- Practice address
- 1010 Lakeland Square Ext Ste B
Flowood, MS 39232-7626 - Phone
- (601) 936-0890
- Fax
- (601) 936-0891
- NPI assigned
- Feb 8, 2017
- Last updated
- Sep 14, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Gregg Miller, MD
- Title
- Authorized Official
- Phone
- (717) 515-4048
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | Primary |
Addresses
Primary practice location
1010 Lakeland Square Ext Ste B
Flowood, MS 39232-7626
Mailing address
PO Box 419663
Boston, MA 02241-9663
Phone (610) 644-8900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02558295 | Medicaid | MS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MS
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170608001741 | MS | Part B Supplier - Ambulatory Surgical Center | 0749558120 | Practice locations: Flowood, MS |
Care Compare: Ambulatory surgical center
Medicare Care Compare- Listed as
- Flowood Vascular Access ASC LLC
- Medicare certification status
- Active
National Provider Directory
National Provider DirectoryMember of 3
Organizations this organization is a member of, according to the National Provider Directory.
-
dba RCC Sebring
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Sebring, FL
- NPI 1477665214
Member Of
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Nephrology Physician
- Brooklyn, NY
- NPI 1942273560
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1486512000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1789344000000",
"number": "1710425913",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 419663",
"city": "BOSTON",
"state": "MA",
"postal_code": "022419663",
"telephone_number": "610-644-8900",
"fax_number": "484-924-0053"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1010 LAKELAND SQUARE EXT STE B",
"city": "FLOWOOD",
"state": "MS",
"postal_code": "392327626",
"telephone_number": "601-936-0890",
"fax_number": "601-936-0891"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FLOWOOD VASCULAR ACCESS ASC LLC",
"organizational_subpart": "NO",
"enumeration_date": "2017-02-08",
"last_updated": "2026-09-14",
"certification_date": "2026-09-14",
"status": "A",
"authorized_official_last_name": "MILLER",
"authorized_official_first_name": "GREGG",
"authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
"authorized_official_telephone_number": "717-515-4048",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "261QA1903X",
"taxonomy_group": "",
"desc": "Clinic/Center, Ambulatory Surgical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02558295",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Flowood, MS
- Flowood River Oaks Hma Medical Group, LLC (CarePlus Internal Medicine)
- Flowood River Oaks Hma Medical Group, LLC (Transformation at River Oaks)
- Flowood River Oaks Hma Medical Group, LLC (Reservoir Family Medical Clinic)
- Flowood River Oaks Hma Medical Group, LLC
- Flowood Surgery Center LLC
- Flowood Vascular Access Center Inc
- Flowood Vascular Access, LLC
- Reginald Ford
- Hannah Fortenberry, CRNA
- Denika Fortner
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2026; 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.