CSC Medical, LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R747936 Issued in MS

Legal business name

CSC MEDICAL, LLC

Practice address

1126 Country Club Rd
McComb, MS 39648-5952

Phone

(601) 250-0139

Fax

(601) 250-0139

NPI assigned

Nov 5, 2012

Organization subpart

No

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

Authorized official

Name

Mrs. Linda Cockrell, FNP,BC

Title

Member

Phone

(601) 259-7345

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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

• Glenn Zeidman, DO

  • Family Medicine Physician
  • McComb, MS
  • NPI 1023067360
  NPD (past)

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

{
    "created_epoch": "1352073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393459200000",
    "number": "1972857548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1126 COUNTRY CLUB RD",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396485952",
            "telephone_number": "601-250-0139",
            "fax_number": "601-250-0139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1126 COUNTRY CLUB RD",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396485952",
            "telephone_number": "601-250-0139",
            "fax_number": "601-250-0139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CSC MEDICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-05",
        "last_updated": "2014-02-27",
        "status": "A",
        "authorized_official_last_name": "COCKRELL",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "601-259-7345",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "FNP,BC"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R747936",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL PROVIDER IDENTIFICATION",
            "identifier": "1134163512",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paula Cotton
• Fisher Alan Covin, M.D.
• Micah Kennedy Craft, FNP
• Kelly C Crawford, OTR/L
• Robert L. Crosby III, MD
• CT Stamps Inc
• CT Stamps Inc
• Abolarin Dada, DO
• Patrick Daigle, MD
• Erika Daley

• Family Nurse Practitioner in McComb, MS
• Providers in McComb, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2014; 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.