WIGGINS PRIMARY CARE (NPI# 1740293257) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740293257 |
| Entity Type | Organization |
| Organization Name | WIGGINS PRIMARY CARE |
| Practice Address |
975 Hall St Wiggins MS 39577-2107 |
| Mailing Address |
Po Box 1007 Lucedale MS 39452-1007 |
| Practice Telephone | 6015289119 |
| Practice Fax Number | 6015289193 |
| Mailing Telephone | 6015289119 |
| Mailing Fax Number | 6015289193 |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2019-11-07 |
| Authorized Official Name | MS. KATHY FENDER (ADMINISTRATOR) |
| Authorized Official Telephone | 6019478181 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | MS | Allopathic & Osteopathic Physicians | |
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 00488801 | 05 | |
| MS | MEDICARE CAHABA | C03308 | 01 |
| Street Address |
975 HALL ST |
| City | WIGGINS |
| State | MS |
| Zip Code | 39577-2107 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518906734 | Donald Robert Doran Jr. | Family Medicine | 975 Hall St, Wiggins, MS 39577-2107 | 2006-06-05 |
| 1487127031 | Tristan Diaz | Registered Nurse | 975 Hall St, Wiggins, MS 39577-2107 | 2019-01-07 |
| 1851816797 | Crystal Renee Stafford | Nurse Practitioner | 975 Hall St, Wiggins, MS 39577-2107 | 2017-08-12 |
| 1922381466 | Michelle Mcqueen Johnson | Nurse Practitioner | 975 Hall St, Wiggins, MS 39577-2107 | 2011-09-21 |
| 1346355583 | Glynnis D Randall | Nurse Practitioner | 975 Hall St, Wiggins, MS 39577-2107 | 2006-08-20 |
| 1639182124 | Deepinder S. Burn | Internal Medicine | 975 Hall St, Wiggins, MS 39577-2107 | 2006-08-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689057721 | John Thames | Emergency Medicine | 1428 Azalea Dr S, Wiggins, MS 39577 | 2015-07-07 |
| 1235468190 | Stone County School District | Local Education Agency (LEA) | 214 Critz Street, Wiggins, MS 39577 | 2009-12-23 |
| 1043452493 | Stone County Hospital, Inc | General Acute Care Hospital | 1434 E Central Ave., Wiggins, MS 39577 | 2009-04-01 |
| 1245274414 | James Walter Holmes | Family Medicine | 975 Hall Street, Wiggins, MS 39577 | 2006-06-16 |
| 1891223186 | Christine L Ladner | Nurse Practitioner | 1434 Central Ave E, Wiggins, MS 39577 | 2017-05-31 |
| 1790962637 | The Vision Center Pa | Optometrist | 1113 Central Ave E, Wiggins, MS 39577 | 2008-01-23 |
| 1821009465 | County Discount Drugs, Inc. | Durable Medical Equipment & Medical Supplies | 820 Hall St, Wiggins, MS 39577-2100 | 2006-08-10 |
| 1154430940 | Batson Physical Therapy, Inc. | Clinic/Center | 711 Hall St, Wiggins, MS 39577-2105 | 2006-08-29 |
| 1033723937 | Katherine B Tyree | Physical Therapist | 711 Hall St, Wiggins, MS 39577-2105 | 2020-09-08 |
| 1114569340 | Johelen K Trisler | Physical Therapy Assistant | 711 Hall St, Wiggins, MS 39577-2105 | 2019-10-09 |
| Find all providers in zip 39577 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265486930 | Phc-fort Morgan Inc | Clinic/Center | 226 Main St, Wiggins, CO 80654-1368 | 2006-05-19 |
| 1861650483 | Stone County Hospital, Inc. | Clinic/Center | 1434 Central Ave E, Wiggins, MS 39577-9602 | 2008-05-30 |
| 1952569576 | Stone County Hospital Inc | Clinic/Center | 1434 Central Ave E, Wiggins, MS 39577-9602 | 2008-05-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730786120 | Ochsner Medical Center - Hancock, LLC | Clinic/Center | 2274 Highway 43 S Ste 200, Picayune, MS 39466-8141 | 2020-10-08 |
| 1306460282 | Covington County Hospital | Clinic/Center | 105 Eaton St, Taylorsville, MS 39168-5614 | 2020-06-05 |
| 1871117747 | Covington County Hospital | Clinic/Center | 1039 Highway 42 Ste C, Sumrall, MS 39482-4478 | 2020-06-05 |
| 1194365338 | Bounds Family Medical | Clinic/Center | 870 Main St Ste A, Fayette, MS 39069-5695 | 2020-01-15 |
| 1720649577 | Boa Vida Hospital of Aberdeen, Ms, LLC | Clinic/Center | 19 Third St, Belmont, MS 38827 | 2019-06-24 |
| 1255999611 | Boa Vida Hospital of Aberdeen, Ms LLC | Clinic/Center | 400 3rd Ave 32 West, New Houlka, MS 38850 | 2019-05-31 |
| 1598238545 | South Sunflower County Hospital | Clinic/Center | 1001 West Delta, Moorhead, MS 38761 | 2019-01-02 |
| 1790272185 | Boa Vida Hospital of Aberdeen, Ms, LLC | Clinic/Center | 670 Ms-178, Suite 5, Sherman, MS 38869 | 2018-04-20 |
| 1124515515 | Boa Vida Hospital of Aberdeen, Ms, LLC | Clinic/Center | 2200 5th St N, Columbus, MS 39705-2212 | 2018-04-20 |
| 1205323698 | Boa Vida Hospital of Aberdeen, Ms, LLC | Clinic/Center | 815 2nd Ave N, Columbus, MS 39701-4703 | 2018-04-20 |
| 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.