THE NEUROSURGICAL CENTER (NPI# 1326149956) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326149956 |
| Entity Type | Organization |
| Organization Name | THE NEUROSURGICAL CENTER |
| Practice Address |
55 Physicians Ln Suite 1 Southaven MS 38671-9569 |
| Practice Telephone | 6623495660 |
| Practice Fax Number | 6623495669 |
| Mailing Telephone | 6623495660 |
| Mailing Fax Number | 6623495669 |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2009-02-18 |
| Authorized Official Name | WINSTON CRAIG CLARK (OWNER) |
| Authorized Official Telephone | 6623495660 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207T00000X | Neurological Surgery | MD14839 | TN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | BCBS OF TN | 162898 | 01 |
| MS | BCBS OF MS | 257741290 | 01 |
| TN | 3707531 | 05 | |
| MS | 07659397 | 05 |
| Street Address |
55 PHYSICIANS LN SUITE 1 |
| City | SOUTHAVEN |
| State | MS |
| Zip Code | 38671-9569 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265409064 | Winston Craig Clark | Neurological Surgery | 55 Physicians Ln, Suite 1, Southaven, MS 38671-9569 | 2006-03-01 |
| 1174171441 | Modern Vascular of Southaven, LLC | Radiologic Technologist | 55 Physicians Ln, Southaven, MS 38671-9569 | 2019-08-29 |
| 1689154478 | Roger L Decker | Nurse Practitioner | 55 Physicians Ln, Southaven, MS 38671-9569 | 2018-08-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285196196 | Emma Tinsley-bowles Long | Social Worker | 8786 Northcreek Blvd, Bldg 8 Apt 3, Southaven, MS 38671 | 2019-04-01 |
| 1851847586 | Tiffany Lashea Jones | Adult Companion | 8755 Millbranch Road, Southaven, MS 38671 | 2016-09-01 |
| 1538526140 | Desoto Pediatric Extended Care LLC | Skilled Nursing Facility | 750 Stateline Road East, Southhaven, MS 38671 | 2016-01-27 |
| 1073983052 | Tara Burt | Physical Therapist | 7900 Airways Blvd. Building A, Suite 2, Southaven, MS 38671 | 2015-10-02 |
| 1295160463 | Ideal Community Care,llc | In Home Supportive Care | 8869 Centre Str #3, Southaven, MS 38671 | 2013-09-06 |
| 1578995692 | Gregory Charles Eakins Jr. | Optometrist | 338 Goodman Rd West, Southaven, MS 38671 | 2013-07-31 |
| 1295173169 | Erica R. Martin | Social Worker | 975 Swinnea Rdg Ste 3, Southaven, MS 38671 | 2013-06-12 |
| 1386918431 | Freds Stores of Tennessee Inc | Pharmacy | 710 Church Road, Southaven, MS 38671 | 2012-03-06 |
| 1740565613 | Mary Jeanette Scruggs | Pharmacist | 1011 Goodman Rd, Southaven, MS 38671 | 2011-10-11 |
| 1184919268 | First Pharmacy Services 5 | Pharmacy | 5185a Getwell Rd, Southaven, MS 38671 | 2011-06-16 |
| Find all providers in zip 38671 | ||||
| Taxonomy Code | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265409064 | Winston Craig Clark | Neurological Surgery | 55 Physicians Ln, Suite 1, Southaven, MS 38671-9569 | 2006-03-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407173453 | Menarvia Nixon Gaddis | Neurological Surgery | 1860 Chadwick Dr Ste 305, Jackson, MS 39204-3467 | 2010-04-30 |
| 1346485794 | Lon F Alexander Md Pllc | Neurological Surgery | 1860 Chadwick Dr Ste 205, Jackson, MS 39204-3466 | 2008-12-12 |
| 1144349168 | Delta Physician Practices | Neurological Surgery | 1703 Hospital St, Greenville, MS 38703-3225 | 2007-03-29 |
| 1497872212 | Timothy M. Wiebe | Neurological Surgery | 103 Aldersgate Cir, Hattiesburg, MS 39402-1301 | 2007-03-25 |
| 1174686182 | St. Dominic Medical Associates LLC | Neurological Surgery | 971 Lakeland Dr. Suite 1250, Jackson, MS 39216-0000 | 2006-12-19 |
| 1194895854 | Lowry Neurosurgical Clinic, P.a. | Neurological Surgery | 1007 Jefferson St, Laurel, MS 39440-4350 | 2006-11-09 |
| 1831270560 | Axon | Neurological Surgery | 1860 Chadwick Dr Ste 258, Ste 258, Jackson, MS 39204-3486 | 2006-10-18 |
| 1013008242 | John Adrian Lancon | Neurological Surgery | 971 Lakeland Dr Ste 1250, Jackson, MS 39216-4609 | 2006-09-26 |
| 1649378191 | Robert Scott Davis | Neurological Surgery | 14209 Cook Rd., Suite 200, Memorial Physician Clinics-st Martin Neuro & Spine, Biloxi, MS 39532 | 2006-09-20 |
| 1710997135 | Edward Thomas Cullom IIi | Neurological Surgery | 1029 River Oaks Dr, Flowood, MS 39232-9554 | 2006-08-08 |
| Find all providers with the same taxonomy | ||||
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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.