Larry Wayne Sivils (NPI# 1609885284, PAC ID# 4587643226) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1609885284 |
| PAC ID by PECOS | 4587643226 |
| Professional Enrollment ID | I20101209000091 |
| Full Name | Larry Wayne Sivils |
| Organization Legal Name | MEA PRIMARY CARE PLUS, LLC |
| Address |
5606 Old Canton Rd Jackson MS 39211-4217 |
| Phone Number | 6019573333 |
| Gender | M |
| Medical School | UNIVERSITY OF MISSISSIPPI SCHOOL OF MEDICINE |
| Graduation Year | 1985 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 0941583728 |
| Number of Group Practice Members | 48 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 250048 | ST DOMINIC-JACKSON MEMORIAL HOSPITAL |
| 250001 | UNIVERSITY OF MISSISSIPPI MED CENTER |
| Address | Phone | Organization |
|---|---|---|
| 5606 Old Canton Rd, Jackson, MS 39211-4217 | 6019573333 | MEA PRIMARY CARE PLUS, LLC |
| Organization Legal Name | MEA PRIMARY CARE PLUS, LLC |
| Physicians | 50 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Moumita Do Biswas | Family Medicine | Mea Primary Care Plus, LLC | 106 Lake Vista Pl, Brandon, MS 39047-6384 |
| Heather Haynes Walker | Nurse Practitioner | Mea Primary Care Plus, LLC | 323 Hwy 51, Ridgeland, MS 39157-3428 |
| Brennan F Vaughn | Physician Assistant | Mea Primary Care Plus, LLC | 4204 Clay St, Vicksburg, MS 39183-3438 |
| Bethany Sumerford | Nurse Practitioner | Mea Primary Care Plus, LLC | 498 Hwy 80 E, Mea Primary Care Plu, Clinton, MS 39056-4720 |
| Tyler Ladner | Physician Assistant | Mea Primary Care Plus, LLC | 112 Southlake Cir, Canton, MS 39046-5368 |
| Michael L Brasel | Physician Assistant | Mea Primary Care Plus, LLC | 935 Hwy 51, Madison, MS 39110-8407 |
| Patrise Bennett | Family Medicine | Mea Primary Care Plus, LLC | 1777 Ellis Ave, Jackson, MS 39204-3616 |
| Diana Lynn Entrekin | Family Medicine | Mea Primary Care Plus, LLC | 5606 Old Canton Rd, Jackson, MS 39211-4217 |
| John Brooks | Emergency Medicine | Mea Primary Care Plus, LLC | 342 Gilchrist Dr, Pearl, MS 39208-6671 |
| Robert L Russell | Family Medicine | Mea Primary Care Plus, LLC | 1515 Jefferson St, Laurel, MS 39440-4244 |
| Street Address |
5606 OLD CANTON RD |
| City | JACKSON |
| State | MS |
| Zip | 39211-4217 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Diana Lynn Entrekin | Family Medicine | Mea Primary Care Plus, LLC | 5606 Old Canton Rd, Jackson, MS 39211-4217 |
| David S. Joe | Family Medicine | Mea Primary Care Plus, LLC | 5606 Old Canton Rd, Jackson, MS 39211-4217 |
| William P Howard | Family Medicine | Mea Primary Care Plus, LLC | 5606 Old Canton Rd, Jackson, MS 39211-4217 |
| William Grantham | Family Medicine | Mea Primary Care Plus, LLC | 5606 Old Canton Rd, Jackson, MS 39211-4217 |
| Frank Koe | Emergency Medicine | Mea Primary Care Plus, LLC | 5606 Old Canton Rd, Jackson, MS 39211-4217 |
| Joe Walter Terry Iii | Family Medicine | Mea Primary Care Plus, LLC | 5606 Old Canton Rd, Jackson, MS 39211-4217 |
| Patrick D Whipple | Family Medicine | Mea Primary Care Plus, LLC | 5606 Old Canton Rd, Jackson, MS 39211-4217 |
| Bradley Suggs | Family Medicine | Mea Primary Care Plus, LLC | 5606 Old Canton Rd, Jackson, MS 39211-4217 |
| Stephen A Coachys | Family Medicine | Mea Primary Care Plus, LLC | 5606 Old Canton Rd, Jackson, MS 39211-4217 |
| Susan Mcallister | Family Medicine | Mea Primary Care Plus, LLC | 5606 Old Canton Rd, Jackson, MS 39211-4217 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Christy L Davis | Nurse Practitioner | East Endocrine and Metabolism Pllc | 1551 E County Line Rd, Jackson, MS 39211-1801 |
| Sagar H Patel | Psychiatry | 1059 Ridgewood Pl B, Jackson, MS 39211-2018 | |
| Susan F Snyder | Clinical Social Worker | Ridgewood Clinics Pa | 1059 Ridgewood Pl, Jackson, MS 39211-2018 |
| Nokita T Jones | Nurse Practitioner | Ridgewood Clinics Pa | 1059 Ridgewood Pl, Jackson, MS 39211-2018 |
| Keiella Butler | Nurse Practitioner | Ridgewood Clinics Pa | 1059 Ridgewood Pl, Jackson, MS 39211-2018 |
| Claire Tyler | Clinical Social Worker | Ridgewood Clinics Pa | 1059 Ridgewood Pl, Jackson, MS 39211-2018 |
| Tanita Martin | Clinical Social Worker | Ridgewood Clinics Pa | 1059 Ridgewood Pl, Jackson, MS 39211-2018 |
| Dinesh K Goel | Family Medicine | 6050 I 55 N E Frontage Rd, Medical Clinic of Mississippi, Jackson, MS 39211-2461 | |
| Charles A Benford Sr. | Physical Therapy | 5888 Ridgewood Rd B, Jackson, MS 39211-2644 | |
| Tiffany Sutton | Physical Therapy | Medical Foundation of Central Mississippi Inc | 6250 Old Canton Rd, Jackson, MS 39211-2946 |
| Find all physicians in zip 39211 | |||
| City | JACKSON |
| Zip Code | 39211 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | JACKSON + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Larry Wayne Sivils.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.