NPIMap

Organization Active NPI

Delta Physician Practices

  • Obstetrics & Gynecology Physician
  • Greenville, MS
National Provider Identifier
1891814802
Registry record updated Nov 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
DELTA PHYSICIAN PRACTICES
Practice address
302 Arnold Ave
Greenville, MS 38701-4711
Phone
(662) 335-8919
Fax
(662) 335-2091
NPI assigned
Mar 29, 2007
Last updated
Nov 14, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
DELTA PHSICIAN PRACTICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 14, 2022

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

Authorized official

Name
Iris Stacker
Title
Ceo
Phone
(662) 378-3783

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X Primary
Obstetrics & Gynecology Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LX0001X

Addresses

Primary practice location

302 Arnold Ave
Greenville, MS 38701-4711

Mailing address

PO Box 23998
Jackson, MS 39225-3998
Phone (662) 725-2749

National Provider Directory

National Provider Directory
Tax ID family
Delta Regional Medical15 organizations share this tax ID, including this one
Part of
Delta Regional Medical

Other organizations with this tax ID 14

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

View all 14

Practitioners & affiliated clinicians

Practitioners 8

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": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668384000000",
    "number": "1891814802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23998",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392253998",
            "telephone_number": "662-725-2749",
            "fax_number": "662-725-2741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 ARNOLD AVE",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "387014711",
            "telephone_number": "662-335-8919",
            "fax_number": "662-335-2091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELTA PHYSICIAN PRACTICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DELTA PHSICIAN PRACTICES",
        "enumeration_date": "2007-03-29",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-14",
        "status": "A",
        "authorized_official_last_name": "STACKER",
        "authorized_official_first_name": "IRIS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "662-378-3783"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2022; 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.