Covenant Sleep Clinic of Oxford, LLC

Primary specialty

Sleep Disorder Diagnostic Clinic/CenterTaxonomy code 261QS1200X

Legal business name

COVENANT SLEEP CLINIC OF OXFORD, LLC

Practice address

2908 South Lamar Blvd
Suite 200
Oxford, MS 38655

Phone

(662) 236-7807

Fax

(662) 236-7854

NPI assigned

Feb 19, 2007

Organization subpart

No

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

Authorized official

Name

Kenneth K Gowen III

Title

President

Phone

(662) 236-7807

Specialties & licenses 1

Addresses

Other names 1

• Sleep Unlimited of Oxford, LLC Former legal business name

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404691200000",
    "number": "1922142215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2908 SOUTH LAMAR BLVD",
            "address_2": "SUITE 200",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "38655",
            "telephone_number": "662-236-7807",
            "fax_number": "662-236-7854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2908 SOUTH LAMAR BLVD",
            "address_2": "SUITE 200",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "38655",
            "telephone_number": "662-236-7807",
            "fax_number": "662-236-7854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVENANT SLEEP CLINIC OF OXFORD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-19",
        "last_updated": "2014-07-07",
        "status": "A",
        "authorized_official_last_name": "GOWEN",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "662-236-7807",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "261QS1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Sleep Disorder Diagnostic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sleep Unlimited of Oxford, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Cathy Diane Cossey, REGISTERED NURSE
• Carolyn Chay Costilow
• Lauren F Cotten, SLP
• Ira Lamar Couey, M.D.
• Covenant Counseling P.L.L.C.
• Covenant Sleep Therapeutics
• Stephanie Jill Crawford, MS
• Lydia A. Critcher, MSN, FNP/AGACNP-BC
• Whitney Roberson Crow, FNP-C
• Pamela R Crowder, LMFT

• Sleep Disorder Diagnostic Clinic/Center in Oxford, MS
• Providers in Oxford, 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 Jul 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.