PETAL URGENT CARE LLC (NPI# 1982908877) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982908877 |
| Entity Type | Organization |
| Organization Name | PETAL URGENT CARE LLC |
| Practice Address |
100 Eastbrook Dr Ste 30 Petal MS 39465-6008 |
| Mailing Address |
Po Box 1248 Ocean Springs MS 39566-1248 |
| Practice Telephone | 6013365393 |
| Practice Fax Number | 6016024681 |
| Mailing Telephone | 6013365393 |
| Mailing Fax Number | 6016024681 |
| Enumeration Date | 2011-01-06 |
| Last Update Date | 2014-08-01 |
| Authorized Official Name | MR. RONNIE ALI (CEO) |
| Authorized Official Telephone | 6013365393 |
| 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 | 03704755 | 05 |
| Street Address |
100 EASTBROOK DR STE 30 |
| City | PETAL |
| State | MS |
| Zip Code | 39465-6008 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114291184 | Hang My-thi Nguyen | Nurse Practitioner | 100 Eastbrook Dr Ste 30, Petal, MS 39465-6012 | 2012-03-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164055489 | R&p Elite Services, LLC | Private Vehicle | 68 Springfield Rd., Petal, MS 39465 | 2020-02-14 |
| 1003460544 | Hayden White | Pharmacist | 36 Byrd Dr., Petal, MS 39465 | 2019-08-01 |
| 1134612971 | Chandler Mccarley Hawkins | Dentist | 1115 Evelyn Gandy Parkway, Petal, MS 39465 | 2018-06-06 |
| 1881199818 | Lauren O'neal Garner | Nurse Practitioner | 36 Stadium Drive, Petal, MS 39465 | 2018-03-30 |
| 1700036928 | Petal School District | Registered Nurse | 60 Herrington Road, Petal, MS 39465 | 2008-09-24 |
| 1962679043 | Hattiesburg Eye Clinic Pa | Optometrist | 1223 Hwy 42, Ste 140, Petal, MS 39465 | 2008-05-08 |
| 1023228640 | Noal Baxter Cochran | Marriage & Family Therapist | 80 Lakeland Circle, Petal, MS 39465 | 2007-05-23 |
| 1750596938 | James A Nicholson Dds Pa | Dentist | 120 South 28th Avenue, Hattiesburg, MS 39465 | 2007-05-11 |
| 1356563605 | Petal School District | Registered Nurse | 400 Hillcrest Loop, Petal, MS 39465 | 2007-05-03 |
| 1154480804 | Mary E Thomsen | Orthotic Fitter | 173 Cherry Oak Trail, Petal, MS 39465 | 2006-12-08 |
| Find all providers in zip 39465 | ||||
| Taxonomy Code | 261QU0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Urgent Care |
| Definition to come... |
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|---|---|---|---|---|
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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 |
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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.