Mantachie Rural Health Care, Inc

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

MANTACHIE RURAL HEALTH CARE, INC

Practice address

311 Mustang Drive
Mantachie, MS 38855

Phone

(662) 282-7161

Fax

(662) 282-7536

NPI assigned

Jan 16, 2019

Organization subpart

Yes

Parent organization

MANTACHIE RURAL HEALTH CARE, INCAs reported in NPPES

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

Authorized official

Name

Mrs. Karen Crabb Burns

Title

Office Manager

Phone

(662) 282-4226

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Federally qualified health center certification: CCN 251098

Legal name

MANTACHIE RURAL HEALTH CARE SCHOOL BASE CLINIC

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Nov 6, 2019

Last certification

Nov 6, 2019

Ownership / control type

For profit – partnership

Facility address

311 Mustang Drive
Mantachie, MS 38855

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

CLIA laboratory certificates

Part of

Mantachie Rural Health

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

{
    "created_epoch": "1547596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775952000000",
    "number": "1053885673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5681 HWY 363",
            "city": "MANTACHIE",
            "state": "MS",
            "postal_code": "38855",
            "telephone_number": "662-282-4226",
            "fax_number": "662-282-7946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 MUSTANG DRIVE",
            "city": "MANTACHIE",
            "state": "MS",
            "postal_code": "38855",
            "telephone_number": "662-282-7161",
            "fax_number": "662-282-7536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANTACHIE RURAL HEALTH CARE, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MANTACHIE RURAL HEALTH CARE, INC",
        "enumeration_date": "2019-01-16",
        "last_updated": "2026-04-12",
        "certification_date": "2026-04-12",
        "status": "A",
        "authorized_official_last_name": "BURNS",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "CRABB",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "662-282-4226",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ginger Little
• James Brandon Loden
• Mantachie Pharmacy LLC
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• Mantachie Rural Health Care, Inc
• Mantachie Rural Health Care, Inc
• Mantachie Rural Health Care, Inc
• Mantachie Rural Health Care, Inc. Dental
• Susan Long Newell
• Crystal Jo Nichols, C.F.N.P.

• Federally Qualified Health Center (FQHC) in Mantachie, MS
• Providers in Mantachie, MS by specialty
• Federally Qualified Health Center (FQHC) in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.