THAXTON FAMILY MEDICAL CLINIC LLC (NPI# 1124505912) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124505912 |
| Entity Type | Organization |
| Organization Name | THAXTON FAMILY MEDICAL CLINIC LLC |
| Practice Address |
11145 Highway 6 W Thaxton MS 38871-9024 |
| Practice Telephone | 6624898500 |
| Practice Fax Number | 6624898600 |
| Mailing Telephone | 6624898500 |
| Mailing Fax Number | 6624898600 |
| Enumeration Date | 2018-07-24 |
| Last Update Date | 2018-07-24 |
| Authorized Official Name | MR. KEVIN FLOYD (PROVIDER/MANAGING MEMBER) |
| Authorized Official Telephone | 6622137890 |
| Authorized Official Credential | NP-C |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QP2300X |
Clinic/Center Specialization: Primary Care |
901818 | MS | Ambulatory Health Care Facilities |
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
901818 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
11145 HIGHWAY 6 W |
| City | THAXTON |
| State | MS |
| Zip Code | 38871-9024 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619531662 | Kacie Cameron Hollimon | Nurse Practitioner | 11145 Highway 6 W, Thaxton, MS 38871-9024 | 2019-04-25 |
| 1437622909 | Caitlin Maree Defazio Williams | Nurse Practitioner | 11145 Highway 6 W, Thaxton, MS 38871-9024 | 2019-01-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760035695 | Carley Walker Herndon | Nurse Practitioner | 11145 Ms-6, Thaxton, MS 38871 | 2019-07-19 |
| 1306393830 | Thaxton Medical Clinic, LLC | Nurse Practitioner | 11145 Highway 6 West, Thaxton, MS 38871 | 2016-09-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942808845 | Todd Alan Gearheart | Counselor | 102 Goose Creek Ter, Thaxton, VA 24174-3010 | 2020-10-13 |
| 1760035695 | Carley Walker Herndon | Nurse Practitioner | 11145 Ms-6, Thaxton, MS 38871 | 2019-07-19 |
| 1730659053 | Deneatta Michelle Roarke | Counselor | 1146 Cabin Ridge Rd, Thaxton, VA 24174-3644 | 2018-11-29 |
| 1306393830 | Thaxton Medical Clinic, LLC | Nurse Practitioner | 11145 Highway 6 West, Thaxton, MS 38871 | 2016-09-01 |
| 1235474552 | Family Preservation Services, Inc. | Community/Behavioral Health | 1081 Monorail Cir, Thaxton, VA 24174-3055 | 2012-11-28 |
| 1700886504 | Shady Grove Volunteer Fire and Rescue Department Inc | Ambulance | 101 Shady Grove Dr, Thaxton, VA 24174-2902 | 2005-07-22 |
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376143024 | Desoto Family Wellness Center, LLC | Nurse Practitioner | 3495 Cobblestone Blvd South, Southaven, MS 38672-3867 | 2020-10-30 |
| 1760096127 | Sarah Freeman Adams | Nurse Practitioner | 710 Ms -371, Mooreville, MS 38857 | 2020-09-03 |
| 1295353290 | Ashley Smith Allen | Nurse Practitioner | Rankin Rural Medical Center, 129 Center Street Suite B, Richland, MS 39218 | 2020-07-07 |
| 1619591542 | Kristy S. Franks | Nurse Practitioner | 2803 Cobb Stump Rd, Fulton, MS 38843-7391 | 2020-06-06 |
| 1013543388 | Mallory Elizabeth Boggs | Nurse Practitioner | 159 Fountains Blvd Ste B, Madison, MS 39110-6344 | 2020-03-19 |
| 1265072821 | Settlemires Family Medical Clinic, LLC | Nurse Practitioner | 3198 Highway 72 W, Corinth, MS 38834-9303 | 2020-01-13 |
| 1588211916 | Pattye Dorris | Nurse Practitioner | 415 Us Highway 49 N, Tutwiler, MS 38963-5091 | 2019-08-21 |
| 1457907248 | Tanya Sanderson | Nurse Practitioner | 4208 Ridgemont Drive, Belden, MS 38826 | 2019-08-16 |
| 1720556319 | Julie Smythe Harper | Nurse Practitioner | 86 Berry Rd, Newhebron, MS 39140-5496 | 2018-11-13 |
| 1063912046 | Laquania Williams | Nurse Practitioner | 470 County Road 471, Vardaman, MS 38878-9770 | 2018-02-16 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on THAXTON FAMILY MEDICAL CLINIC LLC.
| 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.