SOUTH RIDGE FAMILY CLINIC, LLC


Address: 80 Hal Crocker Rd, Ellisville, MS 39437-2089
Phone: 6014772221

SOUTH RIDGE FAMILY CLINIC, LLC (NPI# 1881930469) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1881930469
Entity Type Organization
Organization Name SOUTH RIDGE FAMILY CLINIC, LLC
Practice Address 80 Hal Crocker Rd
Ellisville
MS 39437-2089
Practice Telephone 6014772221
Enumeration Date 2012-12-31
Last Update Date 2012-12-31
Authorized Official Name MARLANA HEDGEPETH (OWNER)
Authorized Official Telephone 6014772221
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207Q00000X Family Medicine Allopathic & Osteopathic Physicians

Office Location

Street Address 80 HAL CROCKER RD
City ELLISVILLE
State MS
Zip Code 39437-2089

Providers in the same location

NPI Name Taxonomy Address Enumeration
1265534648 Marlana Perkins Hedgepeth Nurse Practitioner 80 Hal Crocker Rd, Ellisville, MS 39437-2089 2006-09-05

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1881227759 Courtney J. Sims Nurse Practitioner 80 Hal Crocker Road, Ellisville, MS 39437 2020-02-19
1891228581 Magnolia Gardens Assisted Living Assisted Living Facility 303 East Ivy, Ellisville, MS 39437 2017-04-10
1972851814 Dental Group of Ellisville, Pllc Dentist 97 Hal Crocker Road, Ellisville, MS 39437 2012-08-27
1891920518 Amy E Young Speech-Language Pathologist 471 Hwy 590, Ellisville, MS 39437 2009-05-26
1053486852 Natalia Angelia Stevenson Nurse Practitioner Ellisville State School, 1101 Hwy 11 South, Ellisville, MS 39437 2006-11-21
1831275189 Womens Pavilion of South Mississippi, Pllc Obstetrics & Gynecology 1242 Hwy 29 North, Ellisville, MS 39437 2006-10-30
1861578635 Jennifer Reeder Mascagni Nurse Practitioner 1203 Ave B Ste 200, Ellisville, MS 39437 2006-10-27
1851499982 Kathleen Frances Mccoy Physical Therapist 1101 Hwy 11 South, Ellisville, MS 39437 2006-09-20
1861498610 Patricia A. Tibbs Pediatrics 1203 Avenue B, Ellisville, MS 39437 2005-06-27
1700954765 Shelia Dianne Bradford Nurse Practitioner 1203 Avenue B, Ellisville, MS 39437 2006-11-30
Find all providers in zip 39437

Taxonomy Information

Taxonomy Code 207Q00000X
Grouping Allopathic & Osteopathic Physicians
Classification Family Medicine

Taxonomy Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition]
- Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences.
- Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1407151129 Glenn Edward Hogancamp Family Medicine 35 Quail Ave., Ellisville, MO 63021 2011-01-12
1477561728 Joseph R Danford Family Medicine 822 Main St, Ellisville, MS 39437-2425 2006-08-03
1417974080 Jessee Crane Family Medicine 233 Clarkson Rd, Ellisville, MO 63011-2219 2006-07-17
1518378116 William Currie Family Medicine 822 Main St, Ellisville, MS 39437-2425 2014-05-16
1801226287 South Central Clinics, Inc Family Medicine 1203 Avenue B, Ellisville, MS 39437-2080 2013-11-20
1477748648 Shannon L Goldsmith Family Medicine 822 Main St, Ellisville, MS 39437-2425 2007-09-11
1275735458 Cynthia J Poelker Family Medicine 225 Clarkson Rd, Ellisville, MO 63011-2278 2007-06-01
1952513541 Clarissa Jara Allen Family Medicine 225 Clarkson Rd, Ellisville, MO 63011-2278 2007-05-04
1457451775 Hattiesburg Clinic Pa Family Medicine 822 Main St, Ellisville, MS 39437-2425 2006-09-25
1205844560 Omelia Elizabeth Danford Family Medicine 822 Main St, Ellisville, MS 39437-2425 2006-08-03
Find all providers in ELLISVILLE

Competitor

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City ELLISVILLE
Zip Code 39437

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Dataset Information

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.

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