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INDIANOLA WELLNESS CLINIC, LLC
NPI 1508393000
Clinic/Center - Primary Care in Indianola, MS

Active since May 15, 2017
131 MAIN ST, INDIANOLA, MS 38751(662) 303-3743 Get Directions Write a Review

NPPES record last updated: June 16, 2018. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jun 16, 2018, May 15, 2017 (2 updates tracked since 2017).

About Indianola Wellness Clinic, Llc NPPES

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

INDIANOLA WELLNESS CLINIC, LLC (NPI 1508393000) is a healthcare organization registered as a primary care in Indianola, Mississippi and active in the NPI registry since May 2017. The organization lists Kajuandra K Chandler, Manager/owner, as its authorized official.

NPPES Registry Identity

NPI1508393000
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameINDIANOLA WELLNESS CLINIC, LLC
Location Address131 MAIN STIndianola, MS 38751-2849
Mailing Address108 Whittington DrIndianola, MS 38751-3434 · (662) 303-3743
Phone(662) 303-3743
Organization SubpartNo
Authorized OfficialKajuandra K ChandlerManager/owner · (662) 303-3743
Enumeration DateMay 15, 2017
Last NPPES UpdateJune 16, 20182 updates tracked since enumeration
✔ NPI 1508393000 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
License✔ Licensed in MS · 901379
131 MAIN ST, Indianola, MS 38751
Open in Google Maps ↗

Other Identifiers 1

Medicaid03321871MS

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 Indianola Wellness Clinic, LLC's NPI number?

The NPI number for Indianola Wellness Clinic, LLC is 1508393000. It was assigned to this organization in the NPPES registry on May 15, 2017.

Where is Indianola Wellness Clinic, LLC located?

Indianola Wellness Clinic, LLC is located at 131 Main St, Indianola, MS 38751. The listed phone number is (662) 303-3743.

What is Indianola Wellness Clinic, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

When was this NPI record last updated?

The NPPES record for Indianola Wellness Clinic, LLC was last updated on June 16, 2018. NPI Profile syncs with the weekly NPPES data releases published by CMS.