NPIMap

Organization Active NPI

Magnolia General and Vascular Surgery Clinic

  • Surgery Physician
  • Corinth, MS
National Provider Identifier
1982009031
Registry record updated May 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
MAGNOLIA GENERAL AND VASCULAR SURGERY CLINIC
Practice address
611 Alcorn Dr Ste 210
Corinth, MS 38834-9323
Phone
(662) 284-9910
Fax
(662) 284-9970
NPI assigned
Oct 31, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2021

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

Authorized official

Name
Mr. Howard Nelson
Title
VP Physaician Services
Phone
(662) 293-7618

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X Primary
Vascular Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0129X

Addresses

Primary practice location

611 Alcorn Dr Ste 210
Corinth, MS 38834-9323

Mailing address

P.O Box 2040
Corinth, MS 38835-2040
Phone (662) 284-9910

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gvs@magnolia.medalliesdirect.net Direct

National Provider Directory

National Provider Directory

Locations

611 Alcorn Dr
Ste 210
Corinth, MS 38834
Phone (662) 284-9910

Interoperability endpoints

  • Direct secure messaging: gvs@magnolia.medalliesdirect.net

Practitioners & affiliated clinicians

Practitioners 7

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": "1414713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620950400000",
    "number": "1982009031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O BOX 2040",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388352040",
            "telephone_number": "662-284-9910",
            "fax_number": "662-284-9970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 ALCORN DR STE 210",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388349323",
            "telephone_number": "662-284-9910",
            "fax_number": "662-284-9970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA GENERAL AND VASCULAR SURGERY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-31",
        "last_updated": "2021-05-14",
        "certification_date": "2021-05-14",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "HOWARD",
        "authorized_official_title_or_position": "VP PHYSAICIAN SERVICES",
        "authorized_official_telephone_number": "662-293-7618",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gvs@magnolia.medalliesdirect.net",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "611 Alcorn Dr Ste 210",
            "city": "Corinth",
            "state": "MS",
            "country_code": "US",
            "postal_code": "388349323",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Corinth, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2021; 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.