HENSON MEDICAL CLINIC, INC. (NPI# 1336373240) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336373240 |
| Entity Type | Organization |
| Organization Name | HENSON MEDICAL CLINIC, INC. |
| Other Organization Name | URGENT CARE -- LONG BEACH |
| Practice Address |
200 W Railroad St 104 Long Beach MS 39560-4517 |
| Mailing Address |
Po Box 609 Long Beach MS 39560-0609 |
| Practice Telephone | 2288640622 |
| Practice Fax Number | 2288647958 |
| Mailing Telephone | 2288640622 |
| Mailing Fax Number | 2288647958 |
| Enumeration Date | 2009-05-06 |
| Last Update Date | 2009-05-06 |
| Authorized Official Name | MRS. WANDA F. HENSON (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 2288640622 |
| Authorized Official Credential | FNP-BC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
R862256 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
R518328 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| Other Name | Type Code |
|---|---|
| Urgent Care -- Long Beach | Doing Business As Name - Organization |
| Street Address |
200 W RAILROAD ST 104 |
| City | LONG BEACH |
| State | MS |
| Zip Code | 39560-4517 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811909211 | Donald Ray Rayner | Family Medicine | 200 W Railroad St, Long Beach, MS 39560-4517 | 2006-08-13 |
| 1629399068 | Stephanie A. Mcleod | Nurse Practitioner | 200 W Railroad St, Long Beach, MS 39560-4517 | 2010-06-21 |
| 1225239411 | Trenita Lashawn Moore | Nurse Practitioner | 200 W Railroad St, Long Beach, MS 39560-4517 | 2007-05-29 |
| 1750592036 | Urgent Care of Long Beach LLC | Clinic/Center | 200 W Railroad St, Long Beach, MS 39560-4517 | 2007-05-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336660786 | Vitas Laboratory LLC | Clinical Medical Laboratory | 2048 Pineville Road, Suite B, Long Beach, MS 39560 | 2017-07-06 |
| 1760889554 | Laura Catherine Ranson | Physical Therapist | 2 Tower Plaz, Suite B, Community Rehab Center, Long Beach, MS 39560 | 2014-11-24 |
| 1073803714 | Kathleen Ann Williams | Pharmacist | Riteaid #7227 Pharmacy 200 West Railroad St, Suite B, Long Beach, MS 39560 | 2011-04-14 |
| 1609177179 | Robert William Wylie | Hearing Instrument Specialist | 100 Larosa Rd, Ste D, Long Beach, MS 39560 | 2010-11-15 |
| 1891026498 | James Paul Bertinato | Speech-Language Pathologist | 20337 Longview Rd, Long Beach, MS 39560 | 2010-01-21 |
| 1639317274 | Robert A Wiemer Jr. | Pain Medicine | 528-f Klondike Road, Long Beach, MS 39560 | 2009-02-03 |
| 1932362324 | Family Physical Therapy of South Ms LLC | Physical Therapist | 100-a La Rosa Rd, Long Beach, MS 39560 | 2008-07-07 |
| 1952589863 | Miller-whitmer Family Chiropractic | Chiropractor | 125 Jeff Davis Avenue, Long Beach, MS 39560 | 2008-02-01 |
| 1528267333 | Rachel S Conrad Md PC | Family Medicine | 100a Larosa, Long Beach, MS 39560 | 2007-07-12 |
| 1386720241 | Betty Diane Edrington | Registered Nurse | 2 Tower Plaza, Pineville Road, Long Beach, MS 39560 | 2006-10-31 |
| Find all providers in zip 39560 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568061117 | Charisse Christie Magsaysay | Nurse Practitioner | 4508 Atlantic Ave Ste 468a, Long Beach, CA 90807-1520 | 2020-10-23 |
| 1780293886 | Christina Balladin | Nurse Practitioner | 37 E Hudson St, Long Beach, NY 11561-2106 | 2020-07-24 |
| 1598391518 | Samantha Lynne Band | Nurse Practitioner | 360 W Ocean Blvd Apt 406, Long Beach, CA 90802-4606 | 2020-03-21 |
| 1144854472 | Terezia Marie Tarantino | Nurse Practitioner | 542 E Market St, Long Beach, NY 11561-2421 | 2020-02-25 |
| 1619500196 | Mns Healthcare Solutions LLC | Nurse Practitioner | 3802 Hathaway Ave Apt 812, Long Beach, CA 90815-5117 | 2020-02-12 |
| 1588228738 | Jeannet D Ly | Nurse Practitioner | 2100 E Anaheim St Ste B, Long Beach, CA 90804-3419 | 2019-04-23 |
| 1730642166 | Justin Kimberland Jourdan | Nurse Practitioner | 523 Arbor Station Dr, Long Beach, MS 39560-5734 | 2019-04-11 |
| 1447711460 | Giselle Ann Rodriguez Zaragoza | Nurse Practitioner | 5920 Gardenia Ave, Long Beach, CA 90805-4210 | 2019-03-31 |
| 1427515998 | Saury Mamisay | Nurse Practitioner | 3145 Julian Ave, Long Beach, CA 90808-4436 | 2019-02-20 |
| 1932663630 | Agatha Chinyere Osuji | Nurse Practitioner | 3530 Atlantic Ave Ste 101, Long Beach, CA 90807-4569 | 2019-01-27 |
| Find all providers in LONG BEACH | ||||
| City | LONG BEACH |
| Zip Code | 39560 |
Please comment or provide details below to improve the information on HENSON MEDICAL CLINIC, INC..
| 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.