NETTLETON FAMILY MEDICAL CLINIC, INC. NPI 1003005125

Clinic/Center (Primary Care) in Nettleton, MS

Organization Clinic/Center Primary Care

About NETTLETON FAMILY MEDICAL CLINIC, INC.

Nettleton Family Medical Clinic, Inc. is a primary care provider established in Nettleton, Mississippi specializing in clinic/center (primary care) . The NPI number of Nettleton Family Medical Clinic, Inc. is 1003005125 and was assigned on October 2007. The practitioner's primary taxonomy code is 261QP2300X with license number R850606 (MS). The provider is registered as an organization and their NPI record was last updated 8 years ago.

A primary care provider (PCP) like Nettleton Family Medical Clinic, Inc. sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc The authorized official of this NPI record is Mr. Andrew Curry Justice Cfnp (Owner)

NPI

1003005125

Provider NameNETTLETON FAMILY MEDICAL CLINIC, INC.
Provider Location Address1495 MAPLE RD NETTLETON, MS 38858
Provider Mailing Address1495 MAPLE RD NETTLETON, MS, MS 38858
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date10-15-2007
Last Update Date11-13-2012

Primary Taxonomy

Taxonomy Code261QP2300X
ClassificationClinic/Center
TypeAmbulatory Health Care Facilities
SpecializationPrimary Care
License No.R850606
License StateMS

Business Address

NETTLETON FAMILY MEDICAL CLINIC, INC.
1495 MAPLE RD
NETTLETON, MS
ZIP 38858
Phone: (662) 963-9146
Fax: (662) 963-9186

Get Directions

Mailing Address

NETTLETON FAMILY MEDICAL CLINIC, INC.
1495 MAPLE RD
NETTLETON, MS, MS
ZIP 38858
Phone: (662) 963-9146
Fax: (662) 963-9186

Authorized Official

Authorized Official NameMR. ANDREW CURRY JUSTICE CFNP
Authorized Official TitleOWNER
Authorized Official Phone(662) 963-9146

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareR682403MSNo

Taxonomy Description:

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
512G700050MEDICARE UPIN (02)MS
00328681MEDICAID (05)MS

Other Providers at the same location


The following 3 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1427612183BOA VIDA HOSPITAL OF ABERDEEN, MS, LLC
Organization
Clinic/Center (Rural Health)1495 MAPLE RD
NETTLETON, MS 38858
(662) 963-9146
1568610806MR. ANDREW C JUSTICE CFNP
Individual
Nurse Practitioner (Family)1495 MAPLE RD
NETTLETON, MS 38858
(662) 963-9146
1639279425 KAWANNA CORRINE MALONE C.F.N.P.
Individual
Nurse Practitioner (Family)1495 MAPLE RD
NETTLETON, MS 38858
(662) 963-9146

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.