Baptist Medical Clinic - Convenient Care
Organization Active NPI Multi-Specialty Clinic/Center · Flowood, MS
NPI 1013207091 · NPPES record last updated Apr 12, 2011
Key facts
- NPI
- 1013207091
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Multi-Specialty Clinic/Center 261QM1300X
- Legal business name
- BAPTIST MEDICAL CLINIC - CONVENIENT CARE
- Practice address
- 5341 Lakeland Dr
Flowood, MS 39232-6173 - Phone
- (601) 919-2173
- Fax
- (601) 919-9723
- NPI assigned
- Apr 12, 2011
- Organization subpart
- Yes
- Parent organization (as reported)
- MEDICAL FOUNDATION OF CENTRAL MISSISSIPPI
Authorized official
- Name
- Ms. Terri E Parker
- Title
- Medical Clinic Office Coordinator
- Phone
- (601) 292-4261
Other NPIs on the same Medicare enrollment 10
Practitioners 11
-
Shara M Beckwith, CFNP
-
Benjamin B Brown, M.N.A., B.S.N
-
Douglas D Harkins, M.D.
-
Rebecca Lane Herring, FNP-C
-
Samuel T Lawson, M.D.
-
Antonella Marchionna, NP-C
-
Sheon H Mendoza, M.D.
-
Gina B Seago, CFNP
-
Keith Derek Thorne, M.D.
-
Sharon Thompson, PT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040217000380 | MS | Part B Supplier - Clinic/Group Practice | 1153216411 |
Receives reassigned benefits from 436 practitioners 10 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Kosciusko, MS; Madison, MS; McComb, MS; Meridian, MS; Pearl, MS; Richland, MS; Winona, MS; Yazoo City, MS… |
National Provider Directory
- Part of
- Baptist PT - Northtown
Locations
5341 Lakeland Dr
Flowood, MS 39232
Phone (601) 919-1300
102 Lexington Dr
Gluckstadt, MS 39110
Phone (601) 973-1688
7275 S Siwell Rd
Jackson, MS 39272
Phone (601) 373-7722
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Multi-Specialty Clinic/Center | 261QM1300X | Yes |
Addresses
Primary practice location
5341 Lakeland Dr
Flowood, MS 39232-6173
Mailing address
1151 N State St
Suite 504
Jackson, MS 39202-2407
Phone (601) 292-4261
Other providers in Flowood, MS
- Madison Greer Aycock
- Philip A Azordegan
- Back Clinic, LLC
- Abdul G Bahro
- Shimeka Lanette Banks
- Baptist PT - Flowood
- Clifton Barker
- Shymiral Barnes
- Gail Barnett
- Jay Richard Barnhart
All providers in Flowood, MS · Multi-Specialty Clinic/Center in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 12, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.