ACUTE CARE FAMILY MEDICAL CLINIC OF VERONA - NPI 1003300815

Q: What is East Main Family Medical Clinic LLC's NPI number?

The NPI number for East Main Family Medical Clinic LLC is 1003300815. It was assigned to this organization in the NPPES registry on June 15, 2018. The provider is doing business as Acute Care Family Medical Clinic Of Verona.

Q: What is East Main Family Medical Clinic LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

On this page

About Acute Care Family Medical Clinic Of Verona NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ACUTE CARE FAMILY MEDICAL CLINIC OF VERONA (NPI 1003300815) is a healthcare organization registered as a nurse practitioner in Tupelo, Mississippi and active in the NPI registry since June 2018. The organization maintains a secondary practice location in Tupelo and lists Rodney Brian Rodgers, Owner/nurse Practitioner, as its authorized official.

NPPES Registry Identity

NPI1003300815

Entity TypeOrganization

Primary Taxonomy363L00000X

Legal Business NameEAST MAIN FAMILY MEDICAL CLINIC LLC

Location Address1424 E MAIN STTupelo, MS 38804-2956

Mailing Address5024 Raymond AveTupelo, MS 38801-8671 · (662) 432-0782 · Fax (662) 842-3061

Phone(662) 350-3550

Fax(662) 842-3061

Organization SubpartNo

Authorized OfficialRodney Brian RodgersOwner/nurse Practitioner · (662) 350-3550

Enumeration DateJune 15, 2018

Last NPPES UpdateSeptember 8, 20202 updates tracked since enumeration

NPPES CertifiedSeptember 8, 2020

✔ NPI 1003300815 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in MS · R853214

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

1424 E MAIN ST, Tupelo, MS 38804

Open in Google Maps ↗

Other Names 1

Doing Business AsAcute Care Family Medical Clinic Of Verona

Secondary Practice Location 1

Location 15024 Raymond AveTupelo, MS 38801-8671 · Phone (662) 432-0782

Other Identifiers 2

Other1003300815MS · Commercial, Bcbs

Medicaid1003300815MS

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Molina Healthcare.Insurance ›

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SONYA MARIE TOWNSEND FNP

Nurse Practitioner (Family)