NPIMap

Organization Active NPI

Neshoba Family Medical Clinic

  • Pain Medicine Physician
  • Philadelphia, MS
National Provider Identifier
1003092818
Registry record updated Jan 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
License
16407 Issued in MS
Legal business name
NESHOBA FAMILY MEDICAL CLINIC
Practice address
921 W Beacon St
Philadelphia, MS 39350-3229
Phone
(601) 656-6116
Fax
(601) 656-5445
NPI assigned
Jan 11, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Mike Weeks
Title
Cfo
Phone
(601) 663-1367

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208VP0000X 16407 MS Primary

Addresses

Primary practice location

921 W Beacon St
Philadelphia, MS 39350-3229

Mailing address

921 W Beacon St
Philadelphia, MS 39350-3229
Phone (601) 656-6116

National Provider Directory

National Provider Directory

Locations

1003 Holland Ave
Ste 101
Philadelphia, MS 39350
Phone (601) 663-1234

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1200009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200009600000",
    "number": "1003092818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 W BEACON ST",
            "city": "PHILADELPHIA",
            "state": "MS",
            "postal_code": "393503229",
            "telephone_number": "601-656-6116",
            "fax_number": "601-656-5445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 W BEACON ST",
            "city": "PHILADELPHIA",
            "state": "MS",
            "postal_code": "393503229",
            "telephone_number": "601-656-6116",
            "fax_number": "601-656-5445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NESHOBA FAMILY MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-11",
        "last_updated": "2008-01-11",
        "status": "A",
        "authorized_official_last_name": "WEEKS",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "601-663-1367",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "MS",
            "license": "16407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.