NEWSOM HEALTHCARE OF DESOTO COUNTY, LLC (NPI# 1205243649) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205243649 |
| Entity Type | Organization |
| Organization Name | NEWSOM HEALTHCARE OF DESOTO COUNTY, LLC |
| Practice Address |
2906 Goodman Rd W Suite 109 Horn Lake MS 38637-1291 |
| Practice Telephone | 6623938022 |
| Practice Fax Number | 6623938052 |
| Mailing Telephone | 6623938022 |
| Mailing Fax Number | 6623938052 |
| Enumeration Date | 2014-07-17 |
| Last Update Date | 2014-07-22 |
| Authorized Official Name | MRS. SANDRA MATTHEWS NEWSOM (OWNER/PRESIDENT) |
| Authorized Official Telephone | 6623938022 |
| Authorized Official Credential | FNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
R852706 | MS | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 00117535 | 05 |
| Street Address |
2906 GOODMAN RD W SUITE 109 |
| City | HORN LAKE |
| State | MS |
| Zip Code | 38637-1291 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912901521 | Sandra Newsom | Nurse Practitioner | 2906 Goodman Rd W, Suite 109, Horn Lake, MS 38637-1291 | 2005-06-10 |
| 1972751154 | Newsom Healthcare, Inc | Family Medicine | 2906 Goodman Rd W, Suite 109, Horn Lake, MS 38637-1291 | 2008-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184098733 | Wal-mart Stores East, Lp | Technician/Technologist | 4150 Goodman Road West, Horn Lake, MS 38637 | 2015-11-19 |
| 1609116581 | Horn Lake Eyecare Pllc | Optometrist | 2085 Goodman Rd, Horn Lake, MS 38637 | 2013-02-28 |
| 1487806121 | Midsouth Medical Specialties LLC | Pharmacy | 1433 Goodman Rd W, Horn Lake, MS 38637 | 2008-10-14 |
| 1356417992 | William E Middleton Jr Dds Pa | Dentist | 3011 Goodman Road W, Horn Lake, MS 38637 | 2006-11-27 |
| 1104297753 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 4150 Goodman Rd, Horn Lake, MS 38637-0300 | 2015-10-08 |
| 1134617178 | Connie Irene Worley | Pharmacist | 4150 Goodman Rd, Horn Lake, MS 38637-0300 | 2018-04-25 |
| 1598252710 | Justin Mathis | Pharmacist | 4150 Goodman Rd, Horn Lake, MS 38637-0300 | 2018-04-13 |
| 1730686932 | Bradley Thomas Loeffel | Pharmacist | 4150 Goodman Rd, Horn Lake, MS 38637-0300 | 2018-04-12 |
| 1437759388 | Sarah Walls | Private Vehicle | 3765 Hilltop Dr, Horn Lake, MS 38637-1030 | 2020-10-29 |
| 1497901417 | William E. Middleton Jr. | Dentist | 3011 Goodman Rd W, Horn Lake, MS 38637-1103 | 2008-08-10 |
| Find all providers in zip 38637 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073624995 | Memphis Emergency Specialists PC | Clinic/Center | 6426 Highway 51 N, Horn Lake, MS 38637-2474 | 2006-08-31 |
| 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.