Active NPI
Lagrand Elliott
- Early Intervention Provider Agency
- Brandon, MS
National Provider Identifier
1962894014
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Early Intervention Provider Agency
- Practice address
- 107 Meadow Pointe CV
Brandon, MS 39042-5014 - Phone
- (601) 720-1409
- NPI assigned
- Feb 26, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Early Intervention Provider Agency | 252Y00000X | Primary |
Addresses
Primary practice location
107 Meadow Pointe CV
Brandon, MS 39042-5014
Mailing address
107 Meadow Pointe CV
Brandon, MS 39042-5014
Phone (601) 720-1409
Other names 1
- Lagrand Elliott
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1424908800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1430870400000",
"number": "1962894014",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "107 MEADOW POINTE CV",
"city": "BRANDON",
"state": "MS",
"postal_code": "390425014",
"telephone_number": "601-720-1409"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "107 MEADOW POINTE CV",
"city": "BRANDON",
"state": "MS",
"postal_code": "390425014",
"telephone_number": "601-720-1409"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIOTT",
"first_name": "LAGRAND",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-02-26",
"last_updated": "2015-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "252Y00000X",
"taxonomy_group": "",
"desc": "Early Intervention Provider Agency",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "LAGRAND",
"last_name": "ELLIOTT",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Brandon, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.