NPIMap

Organization Active NPI

Neshoba Urgent Care Clinic

  • Family Medicine Physician
  • Philadelphia, MS
National Provider Identifier
1033346044
Registry record updated Jun 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
NESHOBA URGENT CARE CLINIC
Practice address
1003 Holland Ave
Suite 102
Philadelphia, MS 39350-2180
Phone
(601) 663-1423
Fax
(601) 663-1474
NPI assigned
Jun 17, 2009
Last updated
Jun 17, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2009

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

Authorized official

Name
Mrs. Cal Brummund
Title
Cfo
Phone
(601) 663-1423

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

1003 Holland Ave
Suite 102
Philadelphia, MS 39350-2180

Mailing address

1003 Holland Ave
Suite 102
Philadelphia, MS 39350-2180
Phone (601) 663-1423

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1245196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245196800000",
    "number": "1033346044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 HOLLAND AVE",
            "address_2": "SUITE 102",
            "city": "PHILADELPHIA",
            "state": "MS",
            "postal_code": "393502180",
            "telephone_number": "601-663-1423",
            "fax_number": "601-663-1474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 HOLLAND AVE",
            "address_2": "SUITE 102",
            "city": "PHILADELPHIA",
            "state": "MS",
            "postal_code": "393502180",
            "telephone_number": "601-663-1423",
            "fax_number": "601-663-1474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NESHOBA URGENT CARE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-17",
        "last_updated": "2009-06-17",
        "status": "A",
        "authorized_official_last_name": "BRUMMUND",
        "authorized_official_first_name": "CAL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "601-663-1423",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "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 Jun 17, 2009; 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.