NPIMap

Organization Active NPI

Medical Plaza Eye Clinic, P.a.

  • Specialist
  • Meridian, MS
National Provider Identifier
1932372299
Registry record updated Aug 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
05260 Issued in MS
Legal business name
MEDICAL PLAZA EYE CLINIC, P.A.
Practice address
5002 Hwy 39 N
BLDG B
Meridian, MS 39301-1078
Phone
(601) 483-7331
Fax
(601) 483-3721
NPI assigned
Apr 8, 2008
Last updated
Aug 20, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2008

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

Authorized official

Name
Dr. Woody D Davis, M.D.NPI 1154423804
Title
President
Phone
(601) 483-7331

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 05260 MS Primary

Addresses

Primary practice location

5002 Hwy 39 N
BLDG B
Meridian, MS 39301-1078

Mailing address

5002 Hwy 39 N
BLDG B
Meridian, MS 39301-1078
Phone (601) 483-7331

Other identifiers 2

IdentifierTypeStateIssuer
13247MedicaidMS
8525OtherALMEDICAID AL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1207612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219190400000",
    "number": "1932372299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5002 HWY 39 N",
            "address_2": "BLDG B",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393011078",
            "telephone_number": "601-483-7331",
            "fax_number": "601-483-3721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5002 HWY 39 N",
            "address_2": "BLDG B",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393011078",
            "telephone_number": "601-483-7331",
            "fax_number": "601-483-3721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL PLAZA EYE CLINIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-08",
        "last_updated": "2008-08-20",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "WOODY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "601-483-7331",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MS",
            "license": "05260",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "13247",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID AL",
            "identifier": "8525",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2008; 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.