Progressive Physicians Practice

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

16532 Issued in MS

Legal business name

PROGRESSIVE PHYSICIANS PRACTICE

Practice address

8412 Airways Blvd
Southaven, MS 38671-5140

Phone

(662) 536-2100

Fax

(662) 536-2211

NPI assigned

Nov 3, 2006

Last updated

Nov 4, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Remilekun Subedat Adesoji, MDNPI 1043232986

Title

Owner

Phone

(662) 536-2100

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

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.

• Remilekun Subedat Adesoji, M.D

  • Pediatrics Physician
  • Southaven, MS
  • NPI 1043232986
  Medicare reassignment NPD Authorized official
• Gafar Ajani Adesoji, M.D

  • Internal Medicine Physician
  • Southaven, MS
  • NPI 1861414708
  Medicare reassignment NPD

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288828800000",
    "number": "1982783619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1078",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "38671",
            "telephone_number": "662-536-2100",
            "fax_number": "662-536-2211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8412 AIRWAYS BLVD",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386715140",
            "telephone_number": "662-536-2100",
            "fax_number": "662-536-2211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESSIVE PHYSICIANS PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-03",
        "last_updated": "2010-11-04",
        "status": "A",
        "authorized_official_last_name": "ADESOJI",
        "authorized_official_first_name": "REMILEKUN",
        "authorized_official_middle_name": "SUBEDAT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "662-536-2100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "16532",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MS",
            "license": "16591",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01724394",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Premier Gastroenterology, P. C.
• Premier Trans Non Medical Transportation
• Prime Urgent Medical Clinic
• Priority Health and Consultant LLC
• Privy Health, LLC
• Sarah Gehring Provence, MS, RD, LDN, CDCES
• Providence Health, PLLC (Providence Health)
• Timothy Michael Pruitt, DNP
• Merissa Pryor
• Psycamore LLC

• Internal Medicine Physician in Southaven, MS
• Providers in Southaven, MS by specialty
• Internal Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.