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VICKSBURG CLINIC LLC
NPI 1174494975
Clinic/Center - Rural Health in Vicksburg, MS

Active since September 15, 2025
3317 PEMBERTON SQUARE BLVD, VICKSBURG, MS 39180(601) 636-1173(601) 630-9674 Get Directions Write a Review

NPPES record last updated: September 15, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Vicksburg Clinic Llc NPPES

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

VICKSBURG CLINIC LLC (NPI 1174494975) is a healthcare organization registered as a rural health in Vicksburg, Mississippi and active in the NPI registry since September 2025. The organization lists Kristy Music, Director Provider Enrollment / Ao, as its authorized official.

NPPES Registry Identity

NPI1174494975
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameVICKSBURG CLINIC LLC
Location Address3317 PEMBERTON SQUARE BLVDVicksburg, MS 39180-5578
Mailing AddressPo Box 689022Franklin, TN 37068-9022 · (615) 465-7429 · Fax (615) 628-6877
Phone(601) 636-1173
Fax(601) 630-9674
Organization SubpartYes
Authorized OfficialKristy MusicDirector Provider Enrollment / Ao · (615) 465-7377
Enumeration DateSeptember 15, 2025
NPPES CertifiedSeptember 15, 2025
✔ NPI 1174494975 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
3317 PEMBERTON SQUARE BLVD, Vicksburg, MS 39180
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Other Names 1

Other NameMerit Health Medical Group

Other Providers at the Same Location NPPES 2

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

ALLEN BRELAND YELVERTON
Nurse Practitioner
3317 PEMBERTON SQUARE BLVD
VICKSBURG, MS 39180
Warren County (601) 636-1173
MADELEINE GAUL
Registered Nurse
3317 PEMBERTON SQUARE BLVD
VICKSBURG, MS 39180
Warren County (601) 636-1173

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Vicksburg Clinic LLC's NPI number?

The NPI number for Vicksburg Clinic LLC is 1174494975. It was assigned to this organization in the NPPES registry on September 15, 2025. The provider is also known as Merit Health Medical Group.

Where is Vicksburg Clinic LLC located?

Vicksburg Clinic LLC is located at 3317 Pemberton Square Blvd, Vicksburg, MS 39180. The listed phone number is (601) 636-1173.

What is Vicksburg Clinic LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

When was this NPI record last updated?

The NPPES record for Vicksburg Clinic LLC was last updated on September 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.