Organization Active NPI

Mississippi Vision Correction Center, PLLC

  • Specialist
  • Flowood, MS
National Provider Identifier
1962412429
Registry record updated Jun 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
MISSISSIPPI VISION CORRECTION CENTER, PLLC
Practice address
1053 River Oaks Dr
Flowood, MS 39232-9595
Phone
(601) 969-1430
Fax
(601) 709-2117
NPI assigned
Aug 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2018

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

Authorized official

Name
Dr. Leslie B Aden, M.D.NPI 1700805363
Title
Managing Partner
Phone
(601) 969-1430

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

1053 River Oaks Dr
Flowood, MS 39232-9595

Mailing address

1053 River Oaks Dr
Flowood, MS 39232-9595
Phone (601) 969-1430

Other identifiers 1

IdentifierTypeStateIssuer
9015463MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050421001420 MS Part B Supplier - Clinic/Group Practice 0446298699 Receives reassigned benefits from 3 practitioners
Practice locations: Flowood, MS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1962412429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1053 RIVER OAKS DR",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329595",
            "telephone_number": "601-969-1430",
            "fax_number": "601-709-2117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1053 RIVER OAKS DR",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329595",
            "telephone_number": "601-969-1430",
            "fax_number": "601-709-2117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSISSIPPI VISION CORRECTION CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-08",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "ADEN",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "601-969-1430",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9015463",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flowood, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; 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.