Mississippi Vascular Center, PLLC

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

MISSISSIPPI VASCULAR CENTER, PLLC

Practice address

571 E Beasley Rd
Jackson, MS 39206-3042

Phone

(601) 899-3340

Fax

(601) 899-3343

NPI assigned

May 20, 2014

Last updated

May 20, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tunde Olutade, M.D.

Title

Member

Phone

(601) 899-3340

Specialties & licenses 2

Addresses

Locations

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.

• Gary M Davis, MD

  • Nephrology Physician
  • Jackson, MS
  • NPI 1912065251
  NPD (past)
• Babatunde Olutade, MD

  • Nephrology Physician
  • Jackson, MS
  • NPI 1316050750
  NPD (past)

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

{
    "created_epoch": "1400544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400544000000",
    "number": "1841602257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2057",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391582057",
            "telephone_number": "601-899-3340",
            "fax_number": "601-899-3343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "571 E BEASLEY RD",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392063042",
            "telephone_number": "601-899-3340",
            "fax_number": "601-899-3343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSISSIPPI VASCULAR CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-20",
        "last_updated": "2014-05-20",
        "status": "A",
        "authorized_official_last_name": "OLUTADE",
        "authorized_official_first_name": "TUNDE",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "601-899-3340",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mississippi State Hospital (Lighthouse Medical Clinic)
• Mississippi State Hospital at Whitfield (Mississippi State Hospital Community Services Mental Health)
• Mississippi Surgical Center LP (Mississippi Surgical Center)
• Mississippi Urology Clinic, PLLC
• Mississippi Urology Outpatient Surgery Center, LLC
• Mississippi Vision Center
• Mitchell Myers, M.D. (Mississippi Headache Center)
• Allison Mitchell, CCC-SLP
• Anna Carol Mitchell, CPNP-AC/PC
• April Layne Mitchell, PMHNP

• Nephrology Physician in Jackson, MS
• Providers in Jackson, MS by specialty
• Nephrology Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2014; 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.