NPIMap

Organization Active NPI

Paki Inc

Doing business as Central Family Clinic

  • Primary Care Clinic/Center
  • Petal, MS
National Provider Identifier
1033475967
Registry record updated Apr 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
PAKI INC
Doing business as
Central Family Clinic
Practice address
126 W Central Ave
Petal, MS 39465-2314
Phone
(601) 296-2552
Fax
(601) 296-2397
NPI assigned
Apr 4, 2012
Last updated
Apr 4, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2012

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

Authorized official

Name
Mr. Barry Monday
Title
Admin
Phone
(601) 296-2552

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary
Urgent Care Clinic/Center 261QU0200X

Addresses

Primary practice location

126 W Central Ave
Petal, MS 39465-2314

Mailing address

PO Box 17708
Hattiesburg, MS 39404-7708
Phone (601) 296-2552

Other names 1

  • Central Family Clinic Doing business as

National Provider Directory

National Provider Directory

Locations

210 Main St
Collins, MS 39428
Phone (601) 765-2746

126 W Central Ave
Petal, MS 39465

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1333497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333497600000",
    "number": "1033475967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17708",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394047708",
            "telephone_number": "601-296-2552",
            "fax_number": "601-296-2397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 W CENTRAL AVE",
            "city": "PETAL",
            "state": "MS",
            "postal_code": "394652314",
            "telephone_number": "601-296-2552",
            "fax_number": "601-296-2397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAKI INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-04",
        "last_updated": "2012-04-04",
        "status": "A",
        "authorized_official_last_name": "MONDAY",
        "authorized_official_first_name": "BARRY",
        "authorized_official_title_or_position": "ADMIN",
        "authorized_official_telephone_number": "601-296-2552",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Central Family Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Petal, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2012; 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.