Rodgers Medical Clinic

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

RODGERS MEDICAL CLINIC

Practice address

630 Northwest Ave
Durant, MS 39063-3337

Phone

(662) 653-3011

Fax

(662) 653-6423

NPI assigned

Aug 12, 2025

Last updated

Sep 5, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Phillip Eric Rodgers, NPNPI 1619700481

Title

Nurse Practitioner

Phone

(601) 613-7835

Specialties & licenses 1

Addresses

Other names 1

• Rodgers Medical Clinic Other name

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Phillip Eric Rodgers, FNP-C

  • Family Nurse Practitioner
  • Durant, MS
  • NPI 1619700481
  Medicare reassignment NPD Authorized official
• Michael T Beckum, FNP

  • Nurse Practitioner
  • Ruleville, MS
  • NPI 1225242100
  NPD (past)
• Wirt Fletcher Shrock Jr., M.D.

  • Family Medicine Physician
  • Durant, MS
  • NPI 1497843676
  NPD (past)

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

{
    "created_epoch": "1754956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757030400000",
    "number": "1033095617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13418 ATTALA ROAD 4101",
            "city": "SALLIS",
            "state": "MS",
            "postal_code": "391605242",
            "telephone_number": "601-613-7835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 NORTHWEST AVE",
            "city": "DURANT",
            "state": "MS",
            "postal_code": "390633337",
            "telephone_number": "662-653-3011",
            "fax_number": "662-653-6423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RODGERS MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-12",
        "last_updated": "2025-09-05",
        "certification_date": "2025-09-05",
        "status": "A",
        "authorized_official_last_name": "RODGERS",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "ERIC",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "601-613-7835",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rodgers Medical Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Peace Wellness Center, LLC
• Peace Wellness Mobile Unit
• Tiffany Denice Redd
• Bonita T Roby, LPN
• Daryl Roby, DMD
• Phillip Eric Rodgers, FNP-C
• S&M Medical Clinic
• Shannon Pritchard (Holmes County Mobility Equipment)
• Wirt Fletcher Shrock Jr., M.D.
• Marilyn Smith, PMHNP

• Primary Care Clinic/Center in Durant, MS
• Providers in Durant, MS by specialty
• Primary Care Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.