FAMILY MEDICINE ASSOCIATES, PA (NPI# 1033433628) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033433628 |
| Entity Type | Organization |
| Organization Name | FAMILY MEDICINE ASSOCIATES, PA |
| Practice Address |
200 Hospital Dr Tylertown MS 39667-2020 |
| Practice Telephone | 6018765835 |
| Practice Fax Number | 6018765295 |
| Mailing Telephone | 6018765835 |
| Mailing Fax Number | 6018765295 |
| Enumeration Date | 2010-03-25 |
| Last Update Date | 2010-03-25 |
| Authorized Official Name | DR. JULIUS KEITH SPEED (PRESIDENT) |
| Authorized Official Telephone | 6018765835 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 11133 | MS | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 0114413 | 05 |
| Street Address |
200 HOSPITAL DR |
| City | TYLERTOWN |
| State | MS |
| Zip Code | 39667-2020 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891320164 | Katherine Elizabeth Schubert | Nurse Practitioner | 200 Hospital Dr, Tylertown, MS 39667-2020 | 2020-03-07 |
| 1093137309 | Carol Hobgood | Nurse Practitioner | 200 Hospital Dr, Tylertown, MS 39667-2020 | 2014-01-07 |
| 1982964565 | Christopher Blackwell | Nurse Practitioner | 200 Hospital Dr, Tylertown, MS 39667-2020 | 2012-05-17 |
| 1407166762 | Walthall Rural Health Clinic | Family Medicine | 200 Hospital Dr, Tylertown, MS 39667-2020 | 2010-10-20 |
| 1144530403 | Walthal Rural Health Clinic | Internal Medicine | 200 Hospital Dr, Tylertown, MS 39667-2020 | 2010-10-20 |
| 1518275544 | Walthall Rural Health Clinic | Family Medicine | 200 Hospital Dr, Tylertown, MS 39667-2020 | 2010-09-24 |
| 1255649604 | Walthall General Hospital | General Acute Care Hospital | 200 Hospital Dr, Tylertown, MS 39667 | 2010-09-20 |
| 1861674921 | Vonzell Osborne Williams | Internal Medicine | 200 Hospital Dr, Tylertown, MS 39667-2020 | 2007-11-30 |
| 1720182322 | Stephanie Warner | Internal Medicine | 200 Hospital Dr, Tylertown, MS 39667-2020 | 2006-09-12 |
| 1053424093 | Regina A Williams | Nurse Practitioner | 200 Hospital Dr, Tylertown, MS 39667-2020 | 2006-08-16 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891212221 | Lavarshia Newsome-pittman | Pharmacist | 3000 Plaza Drive, Tylertown, MS 39667 | 2017-08-25 |
| 1891171039 | Tanya Marie Holmes-morris | Home Health Aide | 42 West Mt. Olive Rd, Tylertown, MS 39667 | 2015-08-10 |
| 1376776930 | Family Health Care Clinic, Inc. | Clinic/Center | 225 Saint Paul Road, Tylertown, MS 39667 | 2009-08-31 |
| 1427221290 | Family Health Care Clinic, Inc. | Clinic/Center | 113 Enoch St, Tylertown, MS 39667 | 2008-04-11 |
| 1275651879 | John C Barrett | Dentist | 75 Old Hwy 98 E, Tylertown, MS 39667 | 2007-03-26 |
| 1497895551 | L & L Hospice, Inc. | Hospice Care, Community Based | 423 A Beulah, Tylertown, MS 39667 | 2007-02-07 |
| 1114009610 | Ruthie L Lewis | Licensed Practical Nurse | 423a Beulah Avenue, Tylertown, MS 39667 | 2006-10-20 |
| 1245512417 | Walthall General Hospital | Internal Medicine | 100 Hospital Drive, Tylertown, MS 39667 | 2011-09-14 |
| 1407499296 | Belinda May Ratcliff | Pharmacist | 201 Hospital Dr, Tylertown, MS 39667-2019 | 2019-10-23 |
| 1639720717 | Tylertown Pharmacy LLC | Pharmacy | 201 Hospital Dr, Tylertown, MS 39667-2019 | 2019-09-20 |
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| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821032236 | Patricia A. Miller | Family Medicine | 200 Hospital Dr., Tylertown, MS 39667-2020 | 2006-06-15 |
| 1982669636 | David Jameson | Family Medicine | 110 Franklinton St, Tylertown, MS 39667-2736 | 2006-04-18 |
| 1407166762 | Walthall Rural Health Clinic | Family Medicine | 200 Hospital Dr, Tylertown, MS 39667-2020 | 2010-10-20 |
| 1518275544 | Walthall Rural Health Clinic | Family Medicine | 200 Hospital Dr, Tylertown, MS 39667-2020 | 2010-09-24 |
| 1003996281 | Posavanike S Ganaraj | Family Medicine | 250 Hospital Dr, Tylertown, MS 39667-2020 | 2006-10-16 |
| 1154437168 | Kanta Butani | Family Medicine | 250 Hospital Dr, Tylertown, MS 39667-2020 | 2006-08-22 |
| 1366489296 | Kent Como Kyzar | Family Medicine | 200 Hospital Dr, Tylertown, MS 39667-2020 | 2006-05-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952900581 | Maegan Cook Bridges | Family Medicine | 312 Ridge Pointe Dr, Brandon, MS 39042-5035 | 2020-10-24 |
| 1003415266 | Christian Fortenberry | Family Medicine | 786 Lake Harbour Dr, Ridgeland, MS 39157-4303 | 2020-10-20 |
| 1457967226 | Tiffine Lynn Prisock | Family Medicine | 24978 Ms-15, Mathiston, MS 39752 | 2020-09-17 |
| 1851902860 | Jasmine Lester | Family Medicine | 538 Getwell Rd S, Hernando, MS 38632-9585 | 2020-08-12 |
| 1942810569 | Ericka Marcene Williams | Family Medicine | 1031 Northridge Rd Ste A, Baldwyn, MS 38824-1173 | 2020-08-07 |
| 1316557986 | Independent Healthcare Management, Inc | Family Medicine | 376 Simpson Highway 149 Ste 600, Magee, MS 39111-3572 | 2020-08-07 |
| 1164031373 | Rohith Reddy Guduru Venkata | Family Medicine | Delta Regional Medical Center, 1400 E Union St, Greenville, MS 38703 | 2020-07-24 |
| 1831707470 | Rebecca Holmes | Family Medicine | 42 Atley Holmes Rd # Rs, Jayess, MS 39641-8272 | 2020-07-20 |
| 1497373344 | Dhruval Patel | Family Medicine | 564 Cypress Ln Apt 11d, Greenville, MS 38701-7415 | 2020-07-08 |
| 1881211258 | Tiffany Chapman | Family Medicine | 905 S Frontage Rd, Meridian, MS 39301-6113 | 2020-07-01 |
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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.