NPIMap

Organization Active NPI

Corinth Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Corinth, MS
National Provider Identifier
1891790887
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
012 Issued in MS
Legal business name
CORINTH SURGERY CENTER, LLC
Practice address
401 Alcorn Dr
Ste C
Corinth, MS 38834-9067
Phone
(662) 293-2000
Fax
(662) 665-0857
NPI assigned
Jun 16, 2005
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
Ms. Angela Jackson, R.N., B.S.N.
Title
Administrator
Phone
(662) 293-2000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 012 MS Primary

Addresses

Primary practice location

401 Alcorn Dr
Ste C
Corinth, MS 38834-9067

Mailing address

13740 Cypress Terrace Cir
Ste 501-503
Fort Myers, FL 33907-8827
Phone (239) 274-1000

Other identifiers 3

IdentifierTypeStateIssuer
4287023MedicaidTN
3141695OtherTNBC/BS OF TN
00770360MedicaidMS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1891790887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13740 CYPRESS TERRACE CIR",
            "address_2": "STE 501-503",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339078827",
            "telephone_number": "239-274-1000",
            "fax_number": "239-274-1001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 ALCORN DR",
            "address_2": "STE C",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388349067",
            "telephone_number": "662-293-2000",
            "fax_number": "662-665-0857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORINTH SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "662-293-2000",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "R.N., B.S.N."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MS",
            "license": "012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4287023",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF TN",
            "identifier": "3141695",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00770360",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corinth, 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.