MERIDIAN PLASTIC SURGERY PA
Complete NPI Record 1356557755
Specialist in Meridian, MS

NPI Status: Active since May 15, 2007

Contact Information

5002 HIGHWAY 39 N
MERIDIAN, MS
ZIP 39301
Phone: (601) 693-7742
Fax: (601) 484-2465

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Complete NPI Dataset

This page represents the complete record for NPI 1356557755. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1356557755
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 2
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Employer Identification Number EIN: UNAVAIL
The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
The name of the organization provider. If the provider is an organization, this is the legal business name.
Provider First Line Business Mailing Address: 1200 22ND AVE
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address City Name: MERIDIAN
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: MS
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code: 393014009
The date that a record was last updated or changed.
Provider Business Mailing Address Country Code If outside U S : US
The code designating the provider’s gender if the provider is a person.
Provider Business Mailing Address Telephone Number: 6016937742
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider Business Mailing Address Fax Number: 6014842463
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider First Line Business Practice Location Address: 5002 HIGHWAY 39 N
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Provider Business Practice Location Address City Name: MERIDIAN
Provider Business Practice Location Address State Name: MS
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No
Provider Business Practice Location Address Postal Code: 393011078
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 6016937742
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number: 6014842465
The fax number associated with the location address of the provider being identified.
Provider Enumeration Date: 5/15/2007
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 5/12/2020
The date that a record was last updated or changed.
Authorized Official Last Name: HUFF
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First Name: PENNE
The first name of the authorized official.
Authorized Official Title or Position: MANAGER
The title or position of the authorized official.
Authorized Official Telephone Number: 6016937742
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1: 174400000X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Healthcare Provider Primary Taxonomy Switch 1: Y
Is Organization Subpart: N
Authorized Official Name Prefix Text: MRS.
Healthcare Provider Taxonomy Group 1: 193400000X SINGLE SPECIALTY GROUP
NPI Certification Date: 5/12/2020