DEDRI M IVORY MD PLLC – NPI #1508229378
Internal Medicine

An internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and "collagen" diseases.

Health Care Provider Taxonomy Code for Internal Medicine

DEDRI M IVORY MD PLLC is a provider located in VICKSBURG, MS. NPPES has assigned the NPI number 1508229378 to DEDRI M IVORY MD PLLC on March 30, 2016. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “DEDRI M IVORY MD PLLC” is a dba name, the actual legal business name for this organization is RIVER CITY MEDICAL AND ARTHRITIS CENTER LLC. The primary taxonomy selected by this provider is 207RR0500X from the Health Care Provider Taxonomy code set, which is classified as Internal Medicine, specializing in Rheumatology

The NPI profile was previously updated about 9 years ago on Jan 13, 2017. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for DEDRI M IVORY MD PLLC below.

NPI Profile for
RIVER CITY MEDICAL AND ARTHRITIS CENTER LLC

NPI Number
1508229378
Enumeration Date

(more than 10 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
RIVER CITY MEDICAL AND ARTHRITIS CENTER LLC
Doing Business As (dba): DEDRI M IVORY MD PLLC
Primary location
3510 PEMBERTON SQUARE BLVD
VICKSBURG, MS 39180-5506
Phone: (601) 501-6991 Fax: (601) 501-6987
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
DEDRI IVORY
OWNER
Phone: (601) 501-6991
Updated
Identifiers

Identifiers for DEDRI M IVORY MD PLLC

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDMS08551324
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207RR0500X
- Internal Medicine / Rheumatology (Primary)		 MS 21520

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.