Mid-South Retina Associates, LLC
NPI 1639891088ActiveOrganization· Ophthalmology· Olive Branch, MS
Ophthalmology in Olive Branch, Mississippi, registered in NPPES in September 2022, part of Mid-South Retina Associates, LLC. The authorized official on file is Brian Bradberry, Practice Administrator.
Overview
| NPI | 1639891088 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Mid-South Retina Associates, LLC |
| NPI issued | Sep 13, 2022 |
| Last updated in NPPES | Oct 19, 2022 |
| Certified by provider | Oct 19, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Ophthalmology Primary | 207W00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
Other Ophthalmology providers in Olive Branch
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