BLACKWELL'S FAMILY MEDICINE LLC (NPI# 1366003436) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366003436 |
| Entity Type | Organization |
| Organization Name | BLACKWELL'S FAMILY MEDICINE LLC |
| Practice Address |
107 Ball Ave Tylertown MS 39667-2101 |
| Mailing Address |
171 Pigott Easterling Rd Tylertown MS 39667-7222 |
| Practice Telephone | 6013038264 |
| Mailing Telephone | 6013038264 |
| Enumeration Date | 2019-06-27 |
| Last Update Date | 2019-12-19 |
| Authorized Official Name | MR. CHRISOTPHER WILLIAM BLACKWELL (OWNER, PROVIDER) |
| Authorized Official Telephone | 6013038264 |
| 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 |
Ambulatory Health Care Facilities |
| Street Address |
107 BALL AVE |
| City | TYLERTOWN |
| State | MS |
| Zip Code | 39667-2101 |
| 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 |
| 1255649604 | Walthall General Hospital | General Acute Care Hospital | 200 Hospital Dr, Tylertown, MS 39667 | 2010-09-20 |
| 1407499296 | Belinda May Ratcliff | Pharmacist | 201 Hospital Dr, Tylertown, MS 39667-2019 | 2019-10-23 |
| Find all providers in zip 39667 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
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| 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 |
| 1184120883 | Lena Family Medical, Inc. | Clinic/Center | 1107 Grand Avenue, Lena, MS 39094 | 2018-04-02 |
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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.