PICAYUNE URGENT CARE CLINIC, LLC (NPI# 1780723502) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780723502 |
| Entity Type | Organization |
| Organization Name | PICAYUNE URGENT CARE CLINIC, LLC |
| Practice Address |
422 Memorial Blvd Picayune MS 39466-5544 |
| Practice Telephone | 6017982151 |
| Practice Fax Number | 6017982184 |
| Mailing Telephone | 6017982151 |
| Mailing Fax Number | 6017982184 |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2016-01-07 |
| Authorized Official Name | MR. RONNIE ALI (CEO) |
| Authorized Official Telephone | 6017982151 |
| Authorized Official Credential | D.O |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QU0200X |
Clinic/Center Specialization: Urgent Care |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 09921516 | 05 |
| Street Address |
422 MEMORIAL BLVD |
| City | PICAYUNE |
| State | MS |
| Zip Code | 39466-5544 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972771806 | Picayune Family Practice Clinic, LLC | Clinic/Center | 422 Memorial Blvd, Picayune, MS 39466-5544 | 2008-02-13 |
| 1790827335 | Frederick Joseph Deben Jr. | Nurse Practitioner | 422 Memorial Blvd, Picayune, MS 39466 | 2007-02-12 |
| 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 | 261QU0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Urgent Care |
| Definition to come... |
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| 1235619479 | Maxem Health Urgent Care Mccomb | Clinic/Center | 101 Edgewood Dr, Mccomb, MS 39648-2043 | 2018-08-16 |
| 1700372034 | Gmuc of Lucedale, PC | Clinic/Center | 103 W Frontage Rd Ste C, Lucedale, MS 39452-5836 | 2018-07-10 |
| 1285126227 | Medplus Fulton, LLC | Clinic/Center | 407 Interchange Drive, Fulton, MS 38843 | 2018-06-05 |
| 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.