Organization Active NPI

Flowood Vascular Access ASC LLC

  • Ambulatory Surgical Clinic/Center
  • Flowood, MS
National Provider Identifier
1710425913
Registry record updated Sep 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
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, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2026

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

Authorized official

Name
Gregg Miller, MDNPI 1942273560
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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
02558295MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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 LLCCCN 25C0001093
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Member of 3

Organizations this organization is a member of, according to the National Provider Directory.

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.

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

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.

Verify at the official NPI Registry.