Samuel Holdiness (NPI# 1942595202, PAC ID# 8729243084) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1942595202 |
| PAC ID by PECOS | 8729243084 |
| Professional Enrollment ID | I20150821014005 |
| Full Name | Samuel Holdiness |
| Organization Legal Name | PREMIER MEDICAL GROUP OF MISSISSIPPI LLC |
| Address |
407 S Valley St Carthage MS 39051-4051 |
| Phone Number | 6012980333 |
| Gender | M |
| Medical School | UNIVERSITY OF MISSISSIPPI SCHOOL OF MEDICINE |
| Graduation Year | 2011 |
| Primary Specialty | INTERNAL MEDICINE |
| Secondary Specialties | PEDIATRIC MEDICINE |
| Group Practice PAC ID | 8729973623 |
| Number of Group Practice Members | 24 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 251336 | BAPTIST MEDICAL CENTER ATTALA |
| 250001 | UNIVERSITY OF MISSISSIPPI MED CENTER |
| 250102 | MISSISSIPPI BAPTIST MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 407 S Valley St, Carthage, MS 39051-4051 | 6012980333 | PREMIER MEDICAL GROUP OF MISSISSIPPI LLC |
| 332 Hwy 12 W, Kosciusko, MS 39090 | 60120661006106 | PREMIER MEDICAL GROUP OF MISSISSIPPI LLC |
| Organization Legal Name | PREMIER MEDICAL GROUP OF MISSISSIPPI LLC |
| Physicians | 26 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Crystal H Martin | Nurse Practitioner | Premier Medical Group of Mississippi LLC | 407 S Valley St, Carthage, MS 39051-4051 |
| Linda B Cockroft | Nurse Practitioner | Premier Medical Group of Mississippi LLC | 530 Veterans Memorial Dr, Kosciusko, MS 39090-3858 |
| Christi Sims | Physical Therapy | Premier Medical Group of Mississippi LLC | 130 Pkwy Plz, Kosciusko, MS 39090-3217 |
| Michael Holman | Family Medicine | Premier Medical Group of Mississippi LLC | 332 Hwy 12 W, Kosciusko, MS 39090 |
| Robert G Browning | Family Medicine | Premier Medical Group of Mississippi LLC | 332 Hwy 12 W, Kosciusko, MS 39090 |
| Sarah Putt | Occupational Therapy | Premier Medical Group of Mississippi LLC | 130 Pkwy Plz, Kosciusko, MS 39090-3217 |
| Deidra Cockroft | Physical Therapy | Premier Medical Group of Mississippi LLC | 332 Hwy 12 W, Kosciusko, MS 39090 |
| James J Withers | Family Medicine | Premier Medical Group of Mississippi LLC | 407 S Valley St, Carthage, MS 39051-4051 |
| Timothy M South | Nurse Practitioner | Premier Medical Group of Mississippi LLC | 332 Hwy 12 W, Kosciusko, MS 39090 |
| Dorothy Fulgham | Occupational Therapy | Premier Medical Group of Mississippi LLC | 332 Hwy 12 W, Kosciusko, MS 39090 |
| Street Address |
407 S VALLEY ST |
| City | CARTHAGE |
| State | MS |
| Zip | 39051-4051 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Crystal H Martin | Nurse Practitioner | Premier Medical Group of Mississippi LLC | 407 S Valley St, Carthage, MS 39051-4051 |
| James J Withers | Family Medicine | Premier Medical Group of Mississippi LLC | 407 S Valley St, Carthage, MS 39051-4051 |
| Randi A Watkins | Nurse Practitioner | Premier Medical Group of Mississippi LLC | 407 S Valley St, Carthage, MS 39051-4051 |
| D Stanley Hartness | Family Medicine | Premier Medical Group of Mississippi LLC | 407 S Valley St, Carthage, MS 39051-4051 |
| John G Wallace | Family Medicine | Premier Medical Group of Mississippi LLC | 407 S Valley St, Carthage, MS 39051-4051 |
| Kimberly C Agent | Nurse Practitioner | Premier Medical Group of Mississippi LLC | 407 S Valley St, Carthage, MS 39051-4051 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| David Lawrence Moody | Family Medicine | Madden Medical Clinic, LLC | 1071 E Franklin St, Carthage, MS 39051-3699 |
| Amber Atkinson | Nurse Practitioner | Madden Medical Clinic, LLC | 1071 E Franklin St, Carthage, MS 39051-3699 |
| Neil H Simmons | Optometry | 110 N Van Buren St, Carthage, MS 39051-4126 | |
| Minhthu K Nguyen | Optometry | Carthage Eye Clinic Pa | 201 Hwy 16 E, Carthage, MS 39051-4203 |
| Philip Marler | Optometry | Carthage Eye Clinic Pa | 201 Hwy 16 E, Carthage, MS 39051-4203 |
| Stephanie L Wilcher | Occupational Therapy | Performance Therapy LLC | 1018 Hwy 16 E, Carthage, MS 39051-4220 |
| Erin M Settlemir | Qualified Speech Language Pathologist | Performance Therapy LLC | 1018 Hwy 16 E, Carthage, MS 39051-4220 |
| Michael B Wilcher | Physical Therapy | Performance Therapy LLC | 1018 Hwy 16 E, Carthage, MS 39051-4220 |
| Melissa J Young | Occupational Therapy | Performance Therapy LLC | 1018 Hwy 16 E, Carthage, MS 39051-4220 |
| Tommie K Jones | Nurse Practitioner | Baptist Medical Center-leake Inc | 1100 Hwy 16 E, Baptist Leake Primary Care Center, Carthage, MS 39051-4222 |
| Find all physicians in zip 39051 | |||
| City | CARTHAGE |
| Zip Code | 39051 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | CARTHAGE + INTERNAL MEDICINE |
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| 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.