PICAYUNE CLINIC LLC (NPI# 1578564712) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578564712 |
| Entity Type | Organization |
| Organization Name | PICAYUNE CLINIC LLC |
| Other Organization Name | CROSBY MEMORIAL HOSPITAL |
| Practice Address |
801 Goodyear Blvd Picayune MS 39466-3221 |
| Practice Telephone | 6017984711 |
| Practice Fax Number | 6017493187 |
| Mailing Telephone | 6017984711 |
| Mailing Fax Number | 6017493187 |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | STEVE GRIMM (CEO) |
| Authorized Official Telephone | 6017984711 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282NR1301X |
General Acute Care Hospital Specialization: Rural |
12086 | MS | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 00220682 | 05 |
| Other Name | Type Code |
|---|---|
| Crosby Memorial Hospital | Doing Business As Name - Organization |
| Street Address |
801 GOODYEAR BLVD |
| City | PICAYUNE |
| State | MS |
| Zip Code | 39466-3221 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750665592 | Highland Community Clinic Network | Obstetrics & Gynecology | 801 Goodyear Blvd, Picayune, MS 39466-3221 | 2011-09-28 |
| 1164738712 | Deep South Anesthesia, Inc | Nurse Anesthetist, Certified Registered | 801 Goodyear Blvd, Picayune, MS 39466-3221 | 2010-08-20 |
| 1730310335 | Highland Community Clinic Network | Emergency Medicine | 801 Goodyear Blvd, Picayune, MS 39466-3221 | 2009-07-30 |
| 1861677957 | Forrest County General Hospital | Pharmacy | 801 Goodyear Blvd, Picayune, MS 39466-3221 | 2008-01-08 |
| 1306976238 | Forrest County General Hospital | General Acute Care Hospital | 801 Goodyear Blvd, Picayune, MS 39466-3221 | 2007-03-07 |
| 1053447037 | Jed Dean Zak | Nurse Anesthetist, Certified Registered | 801 Goodyear Blvd, Picayune, MS 39466-3221 | 2007-02-26 |
| 1053469700 | Fgh Physician Billing | Family Medicine | 801 Goodyear Blvd, Picayune, MS 39466-3221 | 2007-01-08 |
| 1477636363 | Milton Nicholas Dudenhefer IIi | Nurse Anesthetist, Certified Registered | 801 Goodyear Blvd, Picayune, MS 39466 | 2006-10-23 |
| 1588747489 | Vincent Guy Lombardo | Nurse Anesthetist, Certified Registered | 801 Goodyear Blvd, Picayune, MS 39466 | 2006-10-23 |
| 1649384512 | Acs Emergency Physicians Pa | Emergency Medicine | 801 Goodyear Blvd, Picayune, MS 39466-3221 | 2006-08-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295270684 | Ashley Royerre Talley | Speech-Language Pathologist | 621 W Canal St, Picayune, MS 39466 | 2016-12-21 |
| 1306396213 | Kathy English | Counselor | 102 Roy St, Picayune, MS 39466 | 2016-10-04 |
| 1124379631 | Hancock Medical Health Services, Inc. | Nurse Practitioner | 23350 Highway 43, Picayune, MS 39466 | 2012-09-24 |
| 1578876280 | Joy A. Weidemann | Social Worker | 120 Street A Ste C, Picayune, MS 39466 | 2010-07-22 |
| 1407188477 | Picayune School District | Local Education Agency (LEA) | 706 Goodyear Blvd., Picayune, MS 39466 | 2010-02-02 |
| 1164751079 | Picayune School District Early Head Start | Early Intervention Provider Agency | 1620 Rosa St, Picayune, MS 39466 | 2009-12-24 |
| 1124352505 | Stephanie Deanne Farrell | Speech-Language Pathologist | 201 E. Second Street, Picayune, MS 39466 | 2009-10-01 |
| 1902084007 | Ludwick L Lohnes Dc LLC | Chiropractor | 214 Norwood Street, Picayune, MS 39466 | 2008-01-31 |
| 1932395878 | Prohealth Solutions, Inc | Occupational Therapist | 722 West Canal Street, Picayune, MS 39466 | 2007-09-24 |
| 1669677431 | Terri L Bordelon | Social Worker | 214 N Curran, Suite A, Picayune, MS 39466 | 2007-06-20 |
| Find all providers in zip 39466 | ||||
| Taxonomy Code | 282NR1301X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| Specialization | Rural |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578011417 | State of Mississippi-university of Mississippi Medical Center | General Acute Care Hospital | 965 Avent Dr Ste 100b, Grenada, MS 38901-5045 | 2016-09-21 |
| 1043452493 | Stone County Hospital, Inc | General Acute Care Hospital | 1434 E Central Ave., Wiggins, MS 39577 | 2009-04-01 |
| 1245400423 | Stefanie Patterson Dendy | General Acute Care Hospital | 825 Grand Avenue, Yazoo City, MS 39194 | 2008-03-04 |
| 1154310514 | Oktibbeha County Hospital | General Acute Care Hospital | 400 Hospital Rd, Starkville, MS 39759-2163 | 2005-10-18 |
| 1386644789 | Grenada Lake Medical Center | General Acute Care Hospital | 960 Avent Dr, Grenada, MS 38901-5230 | 2005-07-28 |
| 1265683775 | Clay County Medical | General Acute Care Hospital | 835 Medical Center Dr, West Point, MS 39773-9320 | 2008-10-02 |
| 1053576819 | Leake Memorial Medical Clinic Walnut Grove | General Acute Care Hospital | 110 Park St, Walnut Grove, MS 39189-6526 | 2008-07-22 |
| 1306921887 | Delta Regional Medical Center | General Acute Care Hospital | 1400 E Union St, Greenville, MS 38703-3246 | 2006-10-25 |
| 1083637904 | Marion General Hospital | General Acute Care Hospital | 1560 Sumrall Rd, Columbia, MS 39429-2654 | 2006-07-25 |
| 1093752602 | George County Hospital- Erp | General Acute Care Hospital | 859 Winter St, Lucedale, MS 39452-6603 | 2006-06-01 |
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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.