WATER VALLEY MEDICAL CLINIC LLC (NPI# 1487605499) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487605499 |
| Entity Type | Organization |
| Organization Name | WATER VALLEY MEDICAL CLINIC LLC |
| Practice Address |
712 S Main St Water Valley MS 38965-3334 |
| Mailing Address |
411 Kimmons St Water Valley MS 38965-2404 |
| Practice Telephone | 6624731140 |
| Practice Fax Number | 6624731138 |
| Mailing Telephone | 6624731140 |
| Mailing Fax Number | 6624731138 |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | BOJAN MILICEVIC (OWNER) |
| Authorized Official Telephone | 6624731140 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| Street Address |
712 S MAIN ST |
| City | WATER VALLEY |
| State | MS |
| Zip Code | 38965-3334 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295090009 | Yalobusha Medical Clinic, LLC | Clinic/Center | 712 S Main St, Water Valley, MS 38965-3334 | 2012-07-08 |
| 1659607232 | Cinnamon Caryl Foster | Nurse Practitioner | 712 S Main St, Water Valley, MS 38965 | 2009-11-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083087985 | Family Health Care Clinic, Inc. | Clinic/Center | 102 Blackmur Dr, Water Valley, MS 38965 | 2015-11-02 |
| 1770713893 | Ben F Toole | Counselor | 1285 County Road 151, Water Valley, MS 38965 | 2009-07-23 |
| 1053451880 | North Mississippi Foot Specialists PC | Durable Medical Equipment & Medical Supplies | 630 South Main St, Water Valley, MS 38965 | 2007-02-08 |
| 1003977281 | Barney Lee Pullen Jr. | Dentist | 117 Wood St, Water Valley, MS 38965 | 2006-12-12 |
| 1912070277 | Water Valley Rural Health Paul Odom Md | Clinic/Center | 645 South Main Street, Water Valley, MS 38965 | 2006-11-16 |
| 1255414173 | Family Practice Clinic of Water Valley | Family Medicine | 606 So Main St, Water Valley, MS 38965 | 2006-10-23 |
| 1073609467 | Paul Leroy Odom | Family Medicine | 604 South Main Street, Water Valley, MS 38965 | 2006-10-05 |
| 1730129164 | Quality Medical Service, Inc | Durable Medical Equipment & Medical Supplies | Quality Medical Services, Inc, 48 S Main Street, Water Valley, MS 38965 | 2006-06-07 |
| 1124687207 | Dontavious Toles | Physical Therapy Assistant | 50 Main St, Water Valley, MS 38965 | 2019-06-11 |
| 1669826111 | Antoinette Taylor | Family Medicine | 604 S Main St, Water Valley, MS 38965 | 2016-04-21 |
| Find all providers in zip 38965 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760080337 | Traditions Hospice of Biloxi, LLC | Clinic/Center | 243 Beauvoir Rd Ste B, Biloxi, MS 39531-4008 | 2020-10-15 |
| 1386242097 | Traditions Hospice of Ridgeland, LLC | Clinic/Center | 680 Highway 51 Ste L, Ridgeland, MS 39157-2103 | 2020-10-14 |
| 1346848694 | Hayco LLC | Clinic/Center | 425 S Jackson St, Brookhaven, MS 39601-3817 | 2020-10-09 |
| 1023620135 | Neshoba County General Hospital-nursing Home | Clinic/Center | 406 Stribling St, Philadelphia, MS 39350-3344 | 2020-08-19 |
| 1023628245 | Durrett Health Care LLC | Clinic/Center | 1515 Munsford Dr, New Albany, MS 38652-7407 | 2020-08-03 |
| 1124644968 | First Choice Family Medical Clinic, LLC | Clinic/Center | 50 Highway 388, Brooksville, MS 39739 | 2020-06-17 |
| 1104447507 | Grace & Mercy Healthcare Center | Clinic/Center | 131 Lexington St, Pickens, MS 39146-3914 | 2020-04-27 |
| 1437788908 | Wellness Center | Clinic/Center | 1727 6th St, Meridian, MS 39301-5249 | 2020-04-06 |
| 1669018008 | Maximum Care After Hours Clinic, LLC | Clinic/Center | 212 Highway 61, Shaw, MS 38773-3877 | 2019-11-20 |
| 1598316895 | Florence Health Complex, LLC | Clinic/Center | 130 S Church St, Florence, MS 39073-8478 | 2019-09-27 |
| Find all providers with the same taxonomy | ||||
| City | WATER VALLEY |
| Zip Code | 38965 |
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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.