TISHOMINGO HEALTH CARE ASSOCIATES (NPI# 1740676378) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740676378 |
| Entity Type | Organization |
| Organization Name | TISHOMINGO HEALTH CARE ASSOCIATES |
| Practice Address |
12b Natchez Street Tishomingo MS 38873 |
| Mailing Address |
15921 Boundary Dr Po Box 92 Ashland MS 38603-7740 |
| Practice Telephone | 6624387474 |
| Practice Fax Number | 6624387760 |
| Mailing Telephone | 6622248951 |
| Mailing Fax Number | 6622246801 |
| Enumeration Date | 2015-04-10 |
| Last Update Date | 2015-04-10 |
| Authorized Official Name | JAMES D NUNNALLY (CEO) |
| Authorized Official Telephone | 6622248951 |
| Is Organization Subpart | Y |
| Parent Organization Name | NORTH MISSISSIPPI PRIMARY HEALTH CARE, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 09011971 | 05 |
| Street Address |
12B NATCHEZ STREET |
| City | TISHOMINGO |
| State | MS |
| Zip Code | 38873 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396727590 | Jennifer Rose Pierce | Nurse Practitioner | 12b Natchez St, Tishomingo, MS 38873 | 2005-11-15 |
| 1013267152 | Samantha Joanne Justice | Nurse Practitioner | 1310 Main Street, Tishomingo, MS 38873-3887 | 2012-09-17 |
| 1518058288 | Gatlins Pharmacy Inc | Pharmacy | 18 First Ave, Tishomingo, MS 38873-8441 | 2006-09-27 |
| 1003431610 | Christopher Bishop | Pharmacist | 18 First Ave, Tishomingo, MS 38873-8441 | 2020-06-09 |
| 1447738299 | Jesse Bart Doran | Pharmacist | 18 First Ave, Tishomingo, MS 38873-8441 | 2018-08-03 |
| 1295213056 | Stanley Page | Pharmacist | 18 First Ave, Tishomingo, MS 38873-8441 | 2018-08-03 |
| 1336627181 | Robert Galloway | Pharmacist | 18 First Ave, Tishomingo, MS 38873-8441 | 2018-08-03 |
| 1326672510 | Jennifer Dawn Hopper | Nurse Practitioner | 15 County Road 55, Tishomingo, MS 38873-9100 | 2020-02-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518564343 | Murray State College | Orthopaedic Surgery | 1 Murray Campus St, Tishomingo, OK 73460-3137 | 2020-10-05 |
| 1487111712 | Dianna M. Mowdy | Registered Nurse | 407 Seven Springs Rd, Tishomingo, OK 73460-1032 | 2019-02-22 |
| 1003394263 | Chandra Dawn Justice | Massage Therapist | 101 N Kemp Ave, Tishomingo, OK 73460-1719 | 2018-07-31 |
| 1114463981 | Ladonna Culp | Nurse Practitioner | 311 Lafitte St, Tishomingo, OK 73460-2433 | 2017-01-17 |
| 1326407537 | Zachary Dodd | Case Manager/Care Coordinator | 5601 W Rock Creek Loop, Tishomingo, OK 73460-4433 | 2016-02-16 |
| 1912380742 | Lori Pigg | Speech-Language Pathologist | 508 N. Neshoba, Tishomingo, OK 73460 | 2015-06-29 |
| 1407241748 | Brittany Walker | Case Management | 850 E. Highway 22, Tishomingo, OK 73460 | 2015-04-03 |
| 1427460641 | Elizabeth Mcdonald | Counselor | 512 East 24th, Tishomingo, OK 73460 | 2014-05-22 |
| 1619387131 | Sheri Slaughter | Counselor | 102 N. Neshoba, Tishomingo, OK 73460 | 2014-05-06 |
| 1336559848 | Heather Marlatt | Counselor | 102 North Neshoba, Tishomingo, OK 73460 | 2014-05-06 |
| Find all providers in TISHOMINGO | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598803942 | Family Health Center of Southern Oklahoma Inc | Clinic/Center | 610 E 24th St, Tishomingo, OK 73460-3245 | 2007-02-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871193722 | Coastal Family Health Center, Inc | Clinic/Center | 12424 Highway 57, Vancleave, MS 39565-8608 | 2020-10-29 |
| 1992305445 | Coastal Family Health Center, Inc | Clinic/Center | 5500 Hurley Wade Rd, Moss Point, MS 39562-8548 | 2020-10-26 |
| 1841890399 | Coastal Family Health Center, Inc | Clinic/Center | 10700 Yellow Jacket Rd, Ocean Springs, MS 39564-8038 | 2020-10-26 |
| 1033755343 | Access Family Health Services, Inc. | Clinic/Center | 179 Mullen Ave, Nettleton, MS 38858-6033 | 2019-11-21 |
| 1285280180 | Delta Health Center, Inc | Clinic/Center | 506 Washington Avenue, Moorhead, MS 38761 | 2019-08-15 |
| 1265088421 | Delta Health Center, Inc | Clinic/Center | 400 South Blvd, Drew, MS 38737-3508 | 2019-08-14 |
| 1215583356 | Delta Health Center, Inc. | Clinic/Center | 302 College Ave, Indianola, MS 38751-2112 | 2019-08-14 |
| 1063068252 | Delta Health Center, Inc | Clinic/Center | 1101 Oak St, Inverness, MS 38753-8725 | 2019-08-13 |
| 1750937959 | Delta Health Center, Inc | Clinic/Center | 212 E Claiborne St, Sunflower, MS 38778-9640 | 2019-08-13 |
| 1750937108 | Delta Health Center, Inc | Clinic/Center | 410 L F Packer Dr, Ruleville, MS 38771-3604 | 2019-08-12 |
| Find all providers with the same taxonomy | ||||
| City | TISHOMINGO |
| Zip Code | 38873 |
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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.