NPIMap

Organization Active NPI

Diabetes & Endocrine Institute, PLLC

  • Endocrinology, Diabetes & Metabolism Physician
  • Flowood, MS
National Provider Identifier
1730138231
Registry record updated Jan 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
17286 Issued in MS
Legal business name
DIABETES & ENDOCRINE INSTITUTE, PLLC
Practice address
2610 Courthouse Cir
Flowood, MS 39232-9562
Phone
(601) 932-1223
Fax
(601) 932-1291
NPI assigned
May 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2011

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

Authorized official

Name
Ms. Pat Sriyuktasuth-Woo
Title
Office Manager
Phone
(601) 932-1223

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RE0101X 17286 MS Primary

Addresses

Primary practice location

2610 Courthouse Cir
Flowood, MS 39232-9562

Mailing address

2610 Courthouse Cir
Flowood, MS 39232-9562
Phone (601) 932-1223

Other identifiers 1

IdentifierTypeStateIssuer
545272540OtherMSBLUE CROSS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070312000268 MS Part B Supplier - Clinic/Group Practice 0749383792 Receives reassigned benefits from 6 practitioners
Practice locations: Flowood, MS

National Provider Directory

National Provider Directory
Tax ID family
Diabetes and Endocrine Institute2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 10

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": "1147219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295395200000",
    "number": "1730138231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2610 COURTHOUSE CIR",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329562",
            "telephone_number": "601-932-1223",
            "fax_number": "601-932-1291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2610 COURTHOUSE CIR",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329562",
            "telephone_number": "601-932-1223",
            "fax_number": "601-932-1291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIABETES & ENDOCRINE INSTITUTE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-10",
        "last_updated": "2011-01-19",
        "status": "A",
        "authorized_official_last_name": "SRIYUKTASUTH-WOO",
        "authorized_official_first_name": "PAT",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "601-932-1223",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MS",
            "license": "17286",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "545272540",
            "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 Jan 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.