Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Diva Weight Loss LLC

Organization Health Service Clinic/Center · NPI 1417230186

Diva Weight Loss LLC is a Health Service Clinic/Center in Ridgeland, Mississippi. Licensed in Mississippi. Registered with an NPI since 2011.

Licensed in
MS
In the registry since
2011
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

604 Goodridge Dr Ste A
Ridgeland, MS 39157-4402
Phone: (769) 251-1040
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Health Service Clinic/Center (primary) Taxonomy 261QH0100X · Licence R869964 (MS)

Record details

NPI number1417230186
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Caryn Johnson — Owner · (601) 624-5840
Other names B/Ba Performance Weight Loss And Medispa
NPI enumeratedSeptember 20, 2011
Last updated in NPPESFebruary 13, 2012
Mailing address604 Goodridge Dr, Suite A, Ridgeland, MS 39157-4402

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