Sweet Magnolia Moon, a Sleep Center, LLC

Primary specialty

Sleep Disorder Diagnostic Clinic/CenterTaxonomy code 261QS1200X

Legal business name

SWEET MAGNOLIA MOON, A SLEEP CENTER, LLC

Practice address

6026 U S Highway 98
Suite 3
Hattiesburg, MS 39402-8861

Phone

(601) 268-5222

Fax

(601) 296-3508

NPI assigned

Nov 30, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Bertha J Blanchard, M.D.

Title

Owner

Phone

(601) 268-5222

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1196380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196380800000",
    "number": "1801078951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6026 U S HIGHWAY 98",
            "address_2": "SUITE 3",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394028861",
            "telephone_number": "601-268-5222",
            "fax_number": "601-296-3508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6026 U S HIGHWAY 98",
            "address_2": "SUITE 3",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394028861",
            "telephone_number": "601-268-5222",
            "fax_number": "601-296-3508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SWEET MAGNOLIA MOON, A SLEEP CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-30",
        "last_updated": "2007-11-30",
        "status": "A",
        "authorized_official_last_name": "BLANCHARD",
        "authorized_official_first_name": "BERTHA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-268-5222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QS1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Sleep Disorder Diagnostic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sleep Disorder Diagnostic Clinic/Center in Hattiesburg, MS
• Providers in Hattiesburg, MS by specialty
• Sleep Disorder Diagnostic Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2007; 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.