NPIMap

Organization Active NPI

Cornerstone Women's Center, PLLC

  • Obstetrics & Gynecology Physician
  • Olive Branch, MS
National Provider Identifier
1740316470
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
16676 Issued in MS
Legal business name
CORNERSTONE WOMEN'S CENTER, PLLC
Practice address
6831 Crumpler Blvd
Suite 100
Olive Branch, MS 38654-1927
Phone
(662) 890-5559
Fax
(662) 893-8323
NPI assigned
Feb 26, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Charles G Ryan Jr., M.D.NPI 1548263627
Title
Owner
Phone
(662) 890-5559

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
Obstetrics & Gynecology Physician 207V00000X 16676 MS Primary

Addresses

Primary practice location

6831 Crumpler Blvd
Suite 100
Olive Branch, MS 38654-1927

Mailing address

PO Box 1159
Olive Branch, MS 38654-0940
Phone (662) 890-5559

Other identifiers 1

IdentifierTypeStateIssuer
00121942MedicaidMS

National Provider Directory

National Provider Directory

Locations

6819 Crumpler Blvd
Ste 101
Olive Branch, MS 38654
Phone (662) 890-5559

Practitioners & affiliated clinicians

Practitioners 2

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": "1172448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1740316470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1159",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386540940",
            "telephone_number": "662-890-5559",
            "fax_number": "662-893-8323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6831 CRUMPLER BLVD",
            "address_2": "SUITE 100",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386541927",
            "telephone_number": "662-890-5559",
            "fax_number": "662-893-8323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNERSTONE WOMEN'S CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RYAN",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "662-890-5559",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MS",
            "license": "16676",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00121942",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Olive Branch, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.