SUPERIOR SOLES (NPI# 1104466887) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104466887 |
| Entity Type | Organization |
| Organization Name | SUPERIOR SOLES |
| Practice Address |
1888 Main St Madison MS 39110 |
| Mailing Address |
161 Woodland Dr Madison MS 39110-8751 |
| Practice Telephone | 6015030335 |
| Mailing Telephone | 6015030335 |
| Enumeration Date | 2020-01-10 |
| Last Update Date | 2020-01-10 |
| Authorized Official Name | MS. LARONA RACHELLE SEARCY (FNP) |
| Authorized Official Telephone | 6015030335 |
| Authorized Official Credential | FNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities | ||
| N | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities | ||
| Y | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers |
| Other Name | Type Code |
|---|---|
| Superior Soles | Former Legal Business Name - Organization |
| Street Address |
1888 MAIN ST |
| City | MADISON |
| State | MS |
| Zip Code | 39110 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134784689 | Therapy South - Gluckstadt LLC | Physical Therapist | 1716 Us 51, Ste N, Madison, MS 39110 | 2019-05-09 |
| 1871054098 | Summit Medical Solutions | Durable Medical Equipment & Medical Supplies | 107 Azalea Street, Madison, MS 39110 | 2019-03-29 |
| 1912488198 | Madison Medical Compounding Pharmacy | Pharmacy | 111 Fountains Blvd. Building B Ste. A, Madison, MS 39110 | 2018-08-24 |
| 1679061469 | Nuvena Vein Clinic | Anesthesiology | 120 Fountains Blvd, Madison, MS 39110 | 2018-04-26 |
| 1467960484 | Brick City Drugs, LLC | Durable Medical Equipment & Medical Supplies | 159 Fountains Blvd, Madison, MS 39110 | 2018-01-11 |
| 1093227589 | Hannah Monk Hawthorne | Counselor | 930 Ebenezer Blvd., Suite D, Madisin, MS 39110 | 2017-10-25 |
| 1548786650 | Kimberly Allen | Pharmacist | 1100 Us- 51, Madison, MS 39110 | 2017-08-21 |
| 1891218186 | Delta Elizabeth Stark | Chiropractor | 1085 Gluckstadt Rd., Bld 300 Ste E, Madison, MS 39110 | 2017-07-19 |
| 1861914848 | Laura Hartlein | Dietitian, Registered | 200 Park Circle Dr. #2, Flowood, MS 39110 | 2017-07-12 |
| 1831620608 | Ona Irby | Occupational Therapist | 105 Munich Dr, Madison, MS 39110 | 2017-03-23 |
| Find all providers in zip 39110 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235740556 | Lucille Elizabeth Nathwani | Nurse Practitioner | Uw Medical Foundation 600 Highland Ave, Madison, WI 53792-0001 | 2020-08-11 |
| 1770193419 | Madison Emergency Group, PC | Nurse Practitioner | 1740 Lions Club Rd, Madison, GA 30650-4762 | 2020-08-07 |
| 1376169920 | Brittany Linton | Nurse Practitioner | 149 Fountains Blvd, Madison, MS 39110-6344 | 2020-06-19 |
| 1811517402 | Lillian Teicher Branham | Nurse Practitioner | 382 Slaughter Rd, Madison, AL 35758-2008 | 2020-04-23 |
| 1275179509 | Claire E P Bergman | Nurse Practitioner | 20 S Park St Ste 360, Madison, WI 53715-1387 | 2019-11-21 |
| 1750923538 | Samuel Scott Mccullough IIi | Nurse Practitioner | 120 Fountains Blvd # 1000, Madison, MS 39110-6343 | 2019-10-12 |
| 1083266779 | Heather Hontzas | Nurse Practitioner | 159 Fountains Blvd Ste A, Madison, MS 39110-6344 | 2019-07-12 |
| 1114404118 | Allison Dyrek | Nurse Practitioner | 20 S Park St Ste 405, Madison, WI 53715-1378 | 2018-07-23 |
| 1851807697 | Kristi M Batchelor | Nurse Practitioner | 20 S Park St Fl 4, Madison, WI 53715 | 2017-12-15 |
| 1366962045 | Katherine Marie Domes | Nurse Practitioner | 5804 Halley Way, Madison, WI 53718-2934 | 2017-06-22 |
| Find all providers in MADISON | ||||
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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.