GREEN TREE FAMILY MEDICAL CLINIC
NPI 1336447861
Clinic/Center - Rural Health in Mt. Olive, MS

NPI Status: Active since March 08, 2011

Contact Information

603 SOUTH MAIN STREET
MT. OLIVE, MS
ZIP 39119
Phone: (601) 797-3405

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  • Organization
  • Clinic/Center
  • Rural Health
  • Accepts Insurance
  • CLIA Number: 25D0317620
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 08-31-2026

About GREEN TREE FAMILY MEDICAL CLINIC

This page provides the complete NPI Profile along with additional information for Green Tree Family Medical Clinic, a primary care provider established in Mt. Olive, Mississippi operating as a Clinic/center, focusing in rural health . The healthcare provider is registered in the NPI registry with number 1336447861 assigned on March 2011. The practitioner's primary taxonomy code is 261QR1300X. The provider is registered as an organization and their NPI record was last updated 15 years ago. The provider's is doing business as Green Tree Family Medical Clinic. The authorized official of this NPI record is Kirstie Evans (Cfo)

NPI
1336447861
Provider Legal Name
COVINGTON COUNTY HOSPITAL
Other Organization Name
GREEN TREE FAMILY MEDICAL CLINIC
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
603 SOUTH MAIN STREET MT. OLIVE, MS 39119
Location Phone
(601) 797-3405
Mailing Address
PO BOX 1107 MOUNT OLIVE, MS 39119
Mailing Phone
(601) 797-3405
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
03-08-2011
Last Update Date
10-05-2011
Code Navigator

A primary care provider (PCP) like Green Tree Family Medical Clinic 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 .

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Rural Health

Taxonomy Code
261QR1300X
Type
Ambulatory Health Care Facilities

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Choice Bronze HSA (QualChoice) - POS
  • Complete Gold - PPO
  • Complete Gold + Vision + Adult Dental - PPO
  • Connected Silver - PPO
  • Connected Silver (QualChoice) - POS
  • Connected Silver (QualChoice) + Vision + Adult Dental - POS
  • Connected Silver (QualChoiceLife) - PPO
  • Connected Silver (QualChoiceLife) + Vision + Adult Dental - PPO
  • Connected Silver + Vision + Adult Dental - PPO
  • Elite Bronze - PPO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • Choice Bronze HSA - HMO
  • Choice Bronze HSA + Vision + Adult Dental - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Everyday Gold - HMO
  • Everyday Gold + Vision + Adult Dental - HMO
  • Standard Expanded Bronze - HMO
  • Standard Expanded Bronze + Vision + Adult Dental - HMO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Molina Gold Standard - HMO
  • Molina Silver Standard - HMO
  • UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
  • UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - HMO
  • UHC Bronze Essential (No Referrals) - HMO
  • UHC Bronze Standard (No Referrals) - HMO
  • UHC Bronze Standard+ (Dental + Vision, No Referrals) - HMO
  • UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) - HMO
  • UHC Gold Copay Focus + $0 Indiv Med Ded ($0 Virtual Urgent Care, $5 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
  • UHC Gold Standard (No Referrals) - HMO
  • UHC Gold Value ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO
  • UHC Gold Value + ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

KIRSTIE EVANS

Authorized Official Title
CFO
Authorized Official Phone
(601) 765-6711

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
253911MEDICARE PIN (08)MS 

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
25D0317620
Facility Type
Physician Office
Certificate Effective Date
September 01, 2024
Certificate Expiration Date
August 31, 2026
Laboratory Director
WORD M. JOHNSTON
Certificate Type
Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description
This CLIA certificate is issued to Green Tree Family Medical Clinic in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1336447861, we treat the final digit (1) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 69. The final step is to find the difference between that total and the next multiple of ten (70 - 69 = 1).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
3
Unchanged
Pos 3
3
Doubled → 6
Pos 4
6
Unchanged
Pos 5
4
Doubled → 8
Pos 6
4
Unchanged
Pos 7
7
Doubled → 14 → 1 + 4
Pos 8
8
Unchanged
Pos 9
6
Doubled → 12 → 1 + 2
Check
1
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 3 → 6 4 → 8 7 → 14 → 5 6 → 12 → 3

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 3 + 6 + 6 + 8 + 4 + 1 + 4 + 8 + 1 + 2 + 24 = 69

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 69 is 70. The difference is the calculated check digit.

70 - 69 = 1
This NPI is valid
The calculated check digit is 1, which matches the last digit of 1336447861.

Other Providers at the Same Location


The following 1 provider is registered at the same or a nearby location.

Family Medicine
603 SOUTH MAIN STREET
MOUNT OLIVE, MS 39119

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1336447861, enumerated as an "organization" on March 08, 2011.

The provider is located at 603 SOUTH MAIN STREET MT. OLIVE, MS 39119 and the phone number is (601) 797-3405.

Clinic/Center with taxonomy code 261QR1300X and a focus in Rural Health.

The provider might be accepting Accepts: Ambetter from Arkansas Health & Wellness, Ambetter. Please consult your insurance carrier or call the provider to verify.