ELEMENTS MEDICAL GROUP OF MISSISSIPPI INC (NPI# 1508386582) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508386582 |
| Entity Type | Organization |
| Organization Name | ELEMENTS MEDICAL GROUP OF MISSISSIPPI INC |
| Practice Address |
3949 Highway 43 N Brandon MS 39047-7240 |
| Mailing Address |
Po Box 671673 Dallas TX 75267-1673 |
| Practice Telephone | 6018292500 |
| Practice Fax Number | 6018294278 |
| Mailing Telephone | 5623039718 |
| Mailing Fax Number | 5622641219 |
| Enumeration Date | 2017-06-21 |
| Last Update Date | 2017-06-21 |
| Authorized Official Name | CHERYL MAPLESDEN (SR DIRECTOR RCM) |
| Authorized Official Telephone | 6155403708 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
MS | Allopathic & Osteopathic Physicians | |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
862194 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
850823 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 207RA0401X |
Internal Medicine Specialization: Addiction Medicine |
7875 | MS | Allopathic & Osteopathic Physicians |
| Street Address |
3949 HIGHWAY 43 N |
| City | BRANDON |
| State | MS |
| Zip Code | 39047-7240 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730289802 | Lloyd James Gordon IIi | Internal Medicine | 3949 Highway 43 N, Brandon, MS 39047-7240 | 2006-09-25 |
| 1609409762 | Defining Wellness Centers Inc. | Substance Abuse Rehabilitation Facility | 3949 Highway 43 N, Brandon, MS 39047-7240 | 2020-02-18 |
| 1306323720 | Pb Mississippi Health Services, LLC | Substance Abuse Rehabilitation Facility | 3949 Highway 43 N, Brandon, MS 39047-7240 | 2018-07-27 |
| 1699175042 | Southeast Behavioral Health Services, Inc. | Substance Abuse Rehabilitation Facility | 3949 Highway 43 N, Brandon, MS 39047-7240 | 2014-09-03 |
| 1235270885 | Copac, Inc. | Substance Abuse Rehabilitation Facility | 3949 Highway 43 N, Brandon, MS 39047-7240 | 2007-02-08 |
| 1376609768 | Susan Henry Taylor | Substance Abuse Rehabilitation Facility | 3949 Highway 43 N, Brandon, MS 39047-7240 | 2006-12-29 |
| 1073679817 | Copac Addiction Services | Substance Abuse Rehabilitation Facility | 3949 Highway 43 N, Brandon, MS 39047-7240 | 2006-12-28 |
| 1801997127 | Karen Holloway | Psychiatry & Neurology | 3949 Highway 43 N, Brandon, MS 39047-7240 | 2006-09-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396368783 | Siyuan Chen Kennedy | Counselor | 108 Sandstone Drive, Brandon, MS 39047 | 2020-05-20 |
| 1568019784 | Juarez Brown Emerson | Registered Nurse | 426 Pinebrook Circle, Brandon, MS 39047 | 2019-08-22 |
| 1649764127 | Specialty Diagnostics LLC | Family Medicine | 1149 Old Fannin Rd Ste 22, Brandon, MS 39047 | 2018-06-19 |
| 1528423035 | Kathlene Strangeman | Social Worker | 111 Lakeshore Dr Apt G403, Brandon, MS 39047 | 2015-12-28 |
| 1174935076 | Anthony Davis | Counselor | 198 Bellegrove Cir, Brandon, MS 39047 | 2014-05-27 |
| 1144659178 | Medical Foundation of Central Ms, Inc | Family Medicine | 1887 Spillway Rd., Brandon, MS 39047 | 2013-11-12 |
| 1437429941 | Picton Timothy Evans | Pharmacist | 150 B Cumberland Ed, Brandon, MS 39047 | 2012-01-01 |
| 1275828030 | Kathryn Audell Piburn | Nurse Practitioner | 1887 Spillway Rd Ste 140, Brandon, MS 39047 | 2011-06-09 |
| 1801930532 | Susanne Reynolds Moore | Dentist | 1149 Old Fannin Rd, Suite 26, Brandon, MS 39047 | 2007-02-16 |
| 1194898429 | Brookshire Grocery Company | Durable Medical Equipment & Medical Supplies | 143 Plaza Drive Ext, Attention Pharmacy Dept, Brandon, MS 39047 | 2006-11-16 |
| Find all providers in zip 39047 | ||||
| Taxonomy Code | 207RA0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Addiction Medicine |
| An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730289802 | Lloyd James Gordon IIi | Internal Medicine | 3949 Highway 43 N, Brandon, MS 39047-7240 | 2006-09-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164518874 | John Thomas Barringer | Internal Medicine | 1551 E County Line Rd, Jackson, MS 39211-1801 | 2006-10-04 |
| 1306840871 | William R. Fellows, Md | Internal Medicine | 180 Debuys Rd, Ste 130, Biloxi, MS 39531-4402 | 2005-06-11 |
| 1104117688 | Gerald B Broussard Jr. | Internal Medicine | 6051 U S Highway 49, Hattiesburg, MS 39401-7200 | 2011-05-02 |
| 1699897066 | Carl Alvin Faulks | Internal Medicine | 450 E Pass Rd, Suite 3, Gulfport, MS 39507-3212 | 2007-04-04 |
| 1396814794 | James J Kramer | Internal Medicine | 405 Fontaine Pl, Suite 101, Ridgeland, MS 39157-5228 | 2006-11-07 |
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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.