LA MISS DIABETIC SHOES (NPI# 1023478435) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023478435 |
| Entity Type | Organization |
| Organization Name | LA MISS DIABETIC SHOES |
| Practice Address |
2200 Highway 61 N Suite 3400 Vicksburg MS 39183-8246 |
| Mailing Address |
139 Southern Ridge Dr Madison MS 39110-9484 |
| Practice Telephone | 6018833342 |
| Practice Fax Number | 6018565955 |
| Mailing Telephone | 6018833342 |
| Mailing Fax Number | 6018565955 |
| Enumeration Date | 2016-02-26 |
| Last Update Date | 2016-02-26 |
| Authorized Official Name | MRS. STEPHANIE F PHELAN (OWNER/PROVIDER) |
| Authorized Official Telephone | 6018833342 |
| Authorized Official Credential | DPM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | 80145 | MS | Suppliers |
| Street Address |
2200 HIGHWAY 61 N SUITE 3400 |
| City | VICKSBURG |
| State | MS |
| Zip Code | 39183-8246 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801827019 | John David Fagan | Urology | 2200 Highway 61 N, Vicksburg, MS 39183-8246 | 2006-07-05 |
| 1154789717 | Carrie Eure | Physician Assistant | 2200 Highway 61 N, Vicksburg, MS 39183-8246 | 2016-02-10 |
| 1861622268 | Vicksburg Clinic LLC | Clinic/Center | 2200 Highway 61 N, Vicksburg, MS 39183-8246 | 2009-07-20 |
| 1356593875 | Hanger Prosthetics & Orthotics, Inc. | Durable Medical Equipment & Medical Supplies | 2200 Highway 61 N, Vicksburg, MS 39183-8246 | 2008-10-15 |
| 1326079518 | Alfred G Windham | Otolaryngology | 2200 Highway 61 N, Vicksburg, MS 39183-8246 | 2006-07-05 |
| 1750312963 | Gloria J Butler | Family Medicine | 2200 Highway 61 N, Vicksburg, MS 39183-8246 | 2006-07-05 |
| 1932130127 | Timothy P Kerut | Allergy & Immunology | 2200 Highway 61 N, Vicksburg, MS 39183-8246 | 2006-07-05 |
| 1811928005 | Thomas K Sligh | Internal Medicine | 2200 Highway 61 N, Vicksburg, MS 39183-8246 | 2006-07-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306217823 | Tracy Curtis | Speech-Language Pathologist | 2100 Us 61, Vicksburg, MS 39183 | 2015-10-09 |
| 1649566894 | The Life Balance Clinic, Behavioral Health Service | Social Worker | 1107 B Openwood St., Vicksburg, MS 39183 | 2011-06-27 |
| 1245428788 | Melanie Joan Waldrop | Nurse Anesthetist, Certified Registered | 2100 Hwy 61n, River Region Medical Center, Vicksburg, MS 39183 | 2007-10-10 |
| 1871714477 | Robert Michael Coleman | Dentist | 2356 Grove Street, Vicksburg, MS 39183 | 2007-05-01 |
| 1942363502 | Visions Physical Therapy | Physical Therapist | 110 Holt Collier Dr, Vicksburg, MS 39183 | 2006-12-18 |
| 1023117991 | Janet S Fisher Dmd Pa | Dentist | 1212 Mission 66, Vicksburg, MS 39183 | 2006-09-21 |
| 1407878663 | Annette Bryant | Social Worker | 1107 Openwood St, Vicksburg, MS 39183 | 2006-07-24 |
| 1932168416 | Promise Hospital of Vicksburg Inc | Long Term Care Hospital | 2100 Highway 61 N Fl 6, Vicksburg, MS 39183 | 2006-03-22 |
| 1164945374 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 2310 Clay St, Vicksburg, MS 39183 | 2017-07-19 |
| 1255777025 | Joyce Wanjugu Muruthi | Obstetrics & Gynecology | 2100 Highway 61 N, Vicksburg, MS 39183 | 2013-05-20 |
| Find all providers in zip 39183 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790329183 | Lan Medical | Durable Medical Equipment & Medical Supplies | 12057 W Indian Lake Dr, Vicksburg, MI 49097-9338 | 2019-10-29 |
| 1740682210 | Mississippi Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 1435 N. Frontage Rd, Vicksburg, MS 39180-5170 | 2014-09-16 |
| 1316261845 | Magnolia Mobility | Durable Medical Equipment & Medical Supplies | 3109 Washington St, Vicksburg, MS 39180-4968 | 2010-03-26 |
| 1194994434 | Patrick Emeka Igbokwe | Durable Medical Equipment & Medical Supplies | 4798 Highway 61 S, Suite B, Vicksburg, MS 39180-7125 | 2008-02-20 |
| 1487725313 | Lincare Inc | Durable Medical Equipment & Medical Supplies | 2480 S Frontage Rd, Ste F, Vicksburg, MS 39180-5251 | 2006-11-13 |
| 1255437844 | Hometown Medical LLC | Durable Medical Equipment & Medical Supplies | 814 Belmont Street, Vicksburg, MS 39180 | 2006-09-15 |
| 1477662864 | Harco Inc | Durable Medical Equipment & Medical Supplies | 2310 Clay Street, Vicksburg, MS 39183-3123 | 2006-08-29 |
| 1013026400 | K & B Mississippi Corp | Durable Medical Equipment & Medical Supplies | 3046 Indiana Avenue, Vicksburg, MS 39180-5252 | 2006-08-29 |
| 1275548430 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 3341 Halls Ferry Rd, Vicksburg, MS 39180-5338 | 2006-07-29 |
| 1982621389 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 2150 Iowa Blvd, Vicksburg, MS 39180-5572 | 2006-07-16 |
| Find all providers in VICKSBURG | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.