GASTROINTESTINAL ASSOCIATES ENDOSCOPY CENTER, LLC (NPI# 1366634669) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366634669 |
| Entity Type | Organization |
| Organization Name | GASTROINTESTINAL ASSOCIATES ENDOSCOPY CENTER, LLC |
| Practice Address |
1815 Mission 66 Vicksburg MS 39180-3709 |
| Mailing Address |
2510 Lakeland Dr Flowood MS 39232-9513 |
| Practice Telephone | 6013551234 |
| Practice Fax Number | 6013263566 |
| Mailing Telephone | 6013551234 |
| Mailing Fax Number | 6013263566 |
| Enumeration Date | 2007-08-10 |
| Last Update Date | 2016-12-06 |
| Authorized Official Name | PIERCE D. DOTHEROW (AUTHORIZED OFFICIAL) |
| Authorized Official Telephone | 6013551234 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | GASTROINTESTINAL ASSOCIATES ENDOSCOPY CENTER, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0800X |
Clinic/Center Specialization: Endoscopy |
25C0001065 | MS | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 04837303 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558553859 | Gastrointestinal Associates Endoscopy Center, LLC | Clinic/Center | 106 Highland Way Ste 101, Madison, MS 39110-6930 | 2007-08-10 |
| 1962663559 | Gastrointestinal Associates Endoscopy Center, LLC | Clinic/Center | 411 Westwood Dr, Wausau, WI 54401 | 2008-06-17 |
| 1245352327 | Gastrointestinal Associates Endoscopy Center, LLC | Clinic/Center | 2510 Lakeland Dr, Flowood, MS 39232-9513 | 2007-04-06 |
| Street Address |
1815 MISSION 66 |
| City | VICKSBURG |
| State | MS |
| Zip Code | 39180-3709 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326003005 | Albert F Chiemprabha | Internal Medicine | 1815 Mission 66, Vicksburg, MS 39180 | 2006-04-18 |
| 1669642096 | James Michael Rainer | Nurse Anesthetist, Certified Registered | 1815 Mission 66, Vicksburg, MS 39180-3709 | 2008-02-29 |
| 1144412438 | Gastrointestinal Associates, P.a. | Pediatrics | 1815 Mission 66, Vicksburg, MS 39180-3709 | 2007-08-10 |
| 1699701060 | Vishwanath N Shenoy | Internal Medicine | 1815 Mission 66, Vicksburg, MS 39180-3709 | 2006-06-25 |
| 1376584425 | Lavinia D Jones | Nurse Anesthetist, Certified Registered | 1815 Mission 66, Vicksburg, MS 39180-3709 | 2006-06-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255877346 | Elite Performance and Rehab, LLC | Clinic/Center | 1901 A Mission 66, Vicksburg, MS 39180 | 2017-01-12 |
| 1679931083 | Heather M Anderson | Physician Assistant | 2080 S Frontage Rd Ste 100, Vicksburg, MS 39180 | 2016-02-01 |
| 1245604941 | Warren County Assn.for Retarded Citizens, Inc. | Day Training, Developmentally Disabled Services | 100 Smokey Lane, Vicksburg, MS 39180 | 2015-11-18 |
| 1386012904 | Brian Oliver Snowden | Counselor | 3530 Manor Dr Ste 5a, Vicksburg, MS 39180 | 2015-09-14 |
| 1962802710 | Jordan P. Crocker, D.m.d., Pllc | Clinic/Center | 109 Monument Place, Vicksburg, MS 39180 | 2014-08-29 |
| 1821434259 | Trisha Addison | Physical Therapist | 2222 South Frontage Road, Suite D, Vicksburg, MS 39180 | 2013-05-13 |
| 1073862157 | Laura Jeanne Briggs | Physical Therapist | 1901-a Mission 66, Vicksburg, MS 39180 | 2012-09-05 |
| 1912175258 | Andrea T. Harris | Counselor | Warren-yazoo Mental Health Service, 3444 Wisconsin Ave., Vicksburg, MS 39180 | 2008-02-20 |
| 1922217314 | Austin Family Dentistry | Dentist | 3040 Indiana Ave, Vicksburg, MS 39180 | 2007-05-22 |
| 1063539138 | Ollie Hardaway Jr. | Dentist | 154 Cottonwood Street, Vicksburg, MS 39180 | 2007-03-23 |
| Find all providers in zip 39180 | ||||
| Taxonomy Code | 261QE0800X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Endoscopy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558553859 | Gastrointestinal Associates Endoscopy Center, LLC | Clinic/Center | 106 Highland Way Ste 101, Madison, MS 39110-6930 | 2007-08-10 |
| 1740264274 | Magnolia Endoscopy Center, LLC | Clinic/Center | 3050 Corder Dr, Corinth, MS 38834-6210 | 2005-11-29 |
| 1255883690 | State of Mississippi - University of Mississippi Medical Center | Clinic/Center | 2500 N State St, Jmm Suite 2525, Jackson, MS 39216-4500 | 2016-11-02 |
| 1932537750 | Digestive Health Endoscopy Asc LLC | Clinic/Center | 90 Industrial Park Cir, Ocean Springs, MS 39564-5800 | 2013-10-15 |
| 1245352327 | Gastrointestinal Associates Endoscopy Center, LLC | Clinic/Center | 2510 Lakeland Dr, Flowood, MS 39232-9513 | 2007-04-06 |
| 1053483735 | Premier Medical Management of Mississippi, Inc | Clinic/Center | 501 Marshall St, Suite 201, Jackson, MS 39202-1651 | 2006-11-15 |
| 1598879009 | Digestive Diseases Center of Hattiesburg, LLC | Clinic/Center | 100 Methodist Hospital Blvd, Hattiesburg, MS 39402-1295 | 2006-08-19 |
Please comment or provide details below to improve the information on GASTROINTESTINAL ASSOCIATES ENDOSCOPY CENTER, LLC.
| 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.