NETTLETON FAMILY MEDICAL CLINIC, INC. (NPI# 1003005125) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003005125 |
| Entity Type | Organization |
| Organization Name | NETTLETON FAMILY MEDICAL CLINIC, INC. |
| Practice Address |
1495 Maple Rd Nettleton MS 38858-6026 |
| Mailing Address |
1495 Maple Rd Nettleton, Ms MS 38858-6026 |
| Practice Telephone | 6629639146 |
| Practice Fax Number | 6629639186 |
| Mailing Telephone | 6629639146 |
| Mailing Fax Number | 6629639186 |
| Enumeration Date | 2007-10-15 |
| Last Update Date | 2012-11-13 |
| Authorized Official Name | MR. ANDREW CURRY JUSTICE (OWNER) |
| Authorized Official Telephone | 6629639146 |
| Authorized Official Credential | CFNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QP2300X |
Clinic/Center Specialization: Primary Care |
R682403 | MS | Ambulatory Health Care Facilities |
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
R850606 | MS | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 00328681 | 05 |
| Street Address |
1495 MAPLE RD |
| City | NETTLETON |
| State | MS |
| Zip Code | 38858-6026 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639279425 | Kawanna Corrine Malone | Nurse Practitioner | 1495 Maple Rd, Nettleton, MS 38858-6026 | 2006-09-22 |
| 1427612183 | Boa Vida Hospital of Aberdeen, Ms, LLC | Clinic/Center | 1495 Maple Rd, Nettleton, MS 38858-6026 | 2019-04-29 |
| 1568610806 | Andrew C Justice | Nurse Practitioner | 1495 Maple Rd, Nettleton, MS 38858-6026 | 2008-08-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518500677 | Nettleton Medical Express Care LLC | General Practice | 7230 Highway 45 N Ste B, 32610 Hwy 45 N, Nettleton, MS 38858 | 2019-10-22 |
| 1467930537 | Michael Anthony Mcbryde | Physical Therapist | 230 Main St., Suite A, Nettleton, MS 38858 | 2018-08-01 |
| 1952813677 | Raquel Ziegler | Physical Therapist | 230-a Main St., Nettleton, MS 38858 | 2017-11-03 |
| 1386843050 | James Andrew Jackson | Dentist | 228 Main St., Nettleton, MS 38858 | 2007-07-13 |
| 1902925340 | John T Hall | Pharmacist | 174a Young Ave, Nettleton, MS 38858 | 2007-03-28 |
| 1063463677 | Sally Lawson Morgan | Nurse Practitioner | 182 W Main St, Nettleton, MS 38858 | 2006-05-16 |
| 1174591044 | Deborra Cassandra Lee | Counselor | 134 Morgan Circle, Nettleton, MS 38858 | 2006-03-08 |
| 1215913074 | Cynthia J Rushing | Nurse Practitioner | 4929 Hwy 351 S, Nettleton, MS 38858 | 2005-12-22 |
| 1295972644 | W. A. Thames, Dmd | Dentist | 228 Main Street, Box 388, Nettleton, MS 38858 | 2009-01-07 |
| 1386868719 | Nettleton Family Clinic | Family Medicine | 182 West Main St, Nettleton, MS 38858 | 2007-04-13 |
| Find all providers in zip 38858 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316556665 | Select Choice At Home Family Care | Clinic/Center | 30007 Carter Orr Dr, Nettleton, MS 38858-8001 | 2020-07-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477176824 | Crystalcare | Clinic/Center | 3124 N Shiloh Road, Corinth, MS 38834 | 2020-05-20 |
| 1134759780 | Family First Clinic of Hernando, Limited | Clinic/Center | 2416 Mount Pleasant Rd, Hernando, MS 38632-2001 | 2020-01-23 |
| 1720640899 | Home In The Woods Healthcare Clinic, LLC | Clinic/Center | 6572 County Road 514, Itta Bena, MS 38941-2746 | 2019-06-28 |
| 1366003436 | Blackwell's Family Medicine LLC | Clinic/Center | 107 Ball Ave, Tylertown, MS 39667-2101 | 2019-06-27 |
| 1710545488 | Primary and Behavioral Healthcare Services, Pa | Clinic/Center | 717 E. Fortification St., Jackson, MS 39202-2402 | 2019-05-29 |
| 1720559354 | Golden Years Geriatrics Inc. | Clinic/Center | 1233 County Road 108, New Albany, MS 38652-9787 | 2018-12-07 |
| 1316421373 | Children's International, LLC | Clinic/Center | 2003 Wildwood Rd, Picayune, MS 39466-2178 | 2018-09-17 |
| 1124505912 | Thaxton Family Medical Clinic LLC | Clinic/Center | 11145 Highway 6 W, Thaxton, MS 38871-9024 | 2018-07-24 |
| 1316439615 | Quad/med, LLC | Clinic/Center | 1000 Jere St. Pe' Hwy, C/o Ingalls Main Substation, 1st Floor, Pascagoula, MS 39567 | 2018-06-01 |
| 1194215681 | Brooks Medical Clinic | Clinic/Center | 2113 South Tate Street, Corinth, MS 38834 | 2018-05-10 |
| Find all providers with the same taxonomy | ||||
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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.