MID-SOUTH RETINA ASSOCIATES, LLC (NPI# 1598700254) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598700254 |
| Entity Type | Organization |
| Organization Name | MID-SOUTH RETINA ASSOCIATES, LLC |
| Practice Address |
3302 W Linden St Corinth MS 38834-9188 |
| Mailing Address |
Po Box 1000 Dept 448 Memphis TN 38148-0448 |
| Practice Telephone | 9016821100 |
| Practice Fax Number | 9016826915 |
| Mailing Telephone | 9016821100 |
| Mailing Fax Number | 9016826915 |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2008-01-24 |
| Authorized Official Name | DR. RICHARD SIEVERS (PARTNER) |
| Authorized Official Telephone | 9016821100 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | MID-SOUTH RETINA ASSOCIATES, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207W00000X | Ophthalmology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | AHS STATE OF MS BC | 465151795 | 01 |
| MS | 04635763 | 05 | |
| MS | BLUE CROSS OF MISSISSIPPI | 465151795B | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861428534 | Mid-south Retina Associates, LLC | Ophthalmology | 820 E Matthews Ave, Suite E, Jonesboro, AR 72401-3048 | 2006-06-24 |
| 1235329145 | Mid-south Retina Associates, LLC | Ophthalmology | 1804 E Shiloh Rd, Corinth, MS 38834-3637 | 2007-07-26 |
| 1447286802 | Mid-south Retina Associates, LLC | Ophthalmology | 609 Skyline Dr, Jackson, TN 38301-3911 | 2006-06-25 |
| 1316973076 | Mid-south Retina Associates, LLC | Ophthalmology | 529 N 10th St, Blytheville, AR 72315-1974 | 2006-06-24 |
| 1689600215 | Mid-south Retina Associates, LLC | Ophthalmology | 401 E Tickle St, Dyersburg, TN 38024-3163 | 2006-06-24 |
| 1215963350 | Mid-south Retina Associates, LLC | Ophthalmology | 6005 Park Ave, Suite 624b, Memphis, TN 38119-5202 | 2006-06-23 |
| 1255376919 | Mid-south Retina Associates, LLC | Ophthalmology | 300 S 8th St, Suite 284w, Murray, KY 42071-2400 | 2006-06-18 |
| Street Address |
3302 W LINDEN ST |
| City | CORINTH |
| State | MS |
| Zip Code | 38834-9188 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477176824 | Crystalcare | Clinic/Center | 3124 N Shiloh Road, Corinth, MS 38834 | 2020-05-20 |
| 1962046680 | Wanda Lee Kilpatrick | Technician | 1206 Breckenridge St., Corinth, MS 38834 | 2019-11-06 |
| 1215595756 | Alanna Nunez Heflin | Dentist | 3127 E Shiloh Rd, Corinth, MS 38834 | 2019-05-30 |
| 1629530795 | A Port In The Storm (apits) | Clinic/Center | 102 N. Cass Street, Suite B, Corinth, MS 38834 | 2019-04-05 |
| 1538654199 | Jerry Wayne Latch | Durable Medical Equipment & Medical Supplies | 206 N Fillmore St, Corinth, MS 38834 | 2018-06-26 |
| 1194215681 | Brooks Medical Clinic | Clinic/Center | 2113 South Tate Street, Corinth, MS 38834 | 2018-05-10 |
| 1164938650 | Pediatric Dentistry of Corinth | Dentist | 1500 N Harper Rd #5, Pediatric Dentistry of Corinth, Corinth, MS 38834 | 2017-12-19 |
| 1467964536 | King Speech-language Therapy, LLC | Speech-Language Pathologist | 2203 Hwy 72 East, Corinth, MS 38834 | 2017-10-30 |
| 1841669728 | Glenda Gatlin | Social Worker | 14 Cr 305, Corinth, MS 38834 | 2015-09-21 |
| 1649646555 | Amanda Word | Social Worker | 303 North Madison Street, Corinth, MS 38834 | 2015-08-14 |
| Find all providers in zip 38834 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043716665 | Shipp & Wooten Eye Center Pllc | Ophthalmology | 306 Bradley Rd Ste B, Corinth, MS 38834-7047 | 2018-04-03 |
| 1598779621 | Jennifer H Garrett | Ophthalmology | 1804 E Shiloh Rd, Corinth, MS 38834-3637 | 2006-07-27 |
| 1306869235 | Crossroad Eye Center LLC | Ophthalmology | 3035 Corder Dr, Corinth, MS 38834-6216 | 2006-07-25 |
| 1457379398 | Bernard Loring Shipp | Ophthalmology | 3302c W Linden St, Corinth, MS 38834-9119 | 2006-07-18 |
| 1619101391 | Garrett Eye Clinic Pllc | Ophthalmology | 1804 E Shiloh Rd, Corinth, MS 38834-3637 | 2009-05-08 |
| 1235329145 | Mid-south Retina Associates, LLC | Ophthalmology | 1804 E Shiloh Rd, Corinth, MS 38834-3637 | 2007-07-26 |
| 1275557613 | Darwin Beshan Wooten | Ophthalmology | 3035 Corder Dr, Corinth, MS 38834-6216 | 2006-07-27 |
| 1043238983 | Shipp Eye Clinic, PC | Ophthalmology | 3302c W Linden St, Corinth, MS 38834-9119 | 2006-07-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417570029 | Vrf Eye Specialty Group, Plc | Ophthalmology | 5800 Delta View Rd, Walls, MS 38680-8341 | 2020-05-19 |
| 1598212755 | James Leighton Pettis Jr. | Ophthalmology | 3 Jackson Sq, Tupelo, MS 38804-2001 | 2016-09-06 |
| 1639532468 | Lee Finley Jones | Ophthalmology | 1501 Lakeland Dr Ste 100, Jackson, MS 39216-4869 | 2016-03-30 |
| 1467832733 | Evelyn Lucile Massey | Ophthalmology | 500 Chris Rd, Clarksdale, MS 38614-9383 | 2015-06-02 |
| 1992145361 | Clayton Stevens | Ophthalmology | 2541 Pass Rd Ste G, Biloxi, MS 39531-2112 | 2013-07-01 |
| 1174833602 | Keith Edward Earley Jr. | Ophthalmology | 301 Fisher Ave, Keesler Afb, MS 39530 | 2010-10-18 |
| 1093941684 | Albert Henlay Laws | Ophthalmology | 200 4th Ave S, Columbus, MS 39701-5645 | 2009-06-09 |
| 1427212992 | James Byron Shipp | Ophthalmology | 2890 S. Lamar, Oxford, MS 38655 | 2008-07-15 |
| 1447412945 | Michael L Wertheimer | Ophthalmology | 726 Goodman Rd E # B, Southaven, MS 38671-9530 | 2008-06-26 |
| 1194984906 | Margaret E Phillips | Ophthalmology | 10051 Lorraine Rd # A-2, Gulfport, MS 39503-6001 | 2008-06-06 |
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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.