NPIMap

Organization Active NPI

Convenient Care Clinic, LLC

  • Rural Health Clinic/Center
  • Batesville, MS
National Provider Identifier
1073246773
Registry record updated Mar 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
CONVENIENT CARE CLINIC, LLC
Practice address
555 Highway 6 E
Batesville, MS 38606-3003
Phone
(662) 578-2030
Fax
(662) 578-2050
NPI assigned
Jul 8, 2022
Last updated
Mar 13, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2025

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

Authorized official

Name
Stephanie Hicks
Title
Controller
Phone
(615) 988-2004

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

555 Highway 6 E
Batesville, MS 38606-3003

Mailing address

30 Burton Hills Blvd Ste 175
Nashville, TN 37215-6403
Phone (615) 864-8713

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220725002208 MS Part A Provider - Rural Health Clinic 1052587284 Practice locations: Batesville, MS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1073246773. Details of each certification follow.

Rural health clinic certification: CCN A53830

Legal name
CONVENIENT CARE CLINIC LLC
Doing business as
BAPTIST URGENT CARE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Nov 17, 2022
Last certification
Nov 17, 2022
Ownership / control type
1B
Organization structure
LLCProprietary
Incorporated
Aug 30, 1999 in MS
Enrollment address
555 Highway 6 E
Batesville, MS 38606-3003

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

555 Highway 6 E
Ste 576
Batesville, MS 38606
Phone (662) 578-2030

3040 Goodman Rd W
Horn Lake, MS 38637
Phone (662) 280-3428

Ownership & related parties

All disclosed owners & managing parties 5

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Convenient Care Clinic LLC Organization, Nashville, TN LLC 5% Or Greater Direct Ownership Interest Sep 12, 2012
Stephanie Hicks Individual Corporate DirectorController Dec 3, 2024
W-2 Managing EmployeeController Dec 3, 2024
Rudy L Blank Individual Corporate DirectorCfo Nov 7, 2016
Urgent Team Management of Mississippi Organization, Nashville, TN LLC 5% Or Greater Direct Ownership Interest Jun 1, 2012
Operational/Managerial Control Jun 1, 2012
Crystal Gibson Individual W-2 Managing EmployeeCredentialing Manager Jun 6, 2022

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 35

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.

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1657238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741824000000",
    "number": "1073246773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 BURTON HILLS BLVD STE 175",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372156403",
            "telephone_number": "615-864-8713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 HIGHWAY 6 E",
            "city": "BATESVILLE",
            "state": "MS",
            "postal_code": "386063003",
            "telephone_number": "662-578-2030",
            "fax_number": "662-578-2050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONVENIENT CARE CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-08",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-13",
        "status": "A",
        "authorized_official_last_name": "HICKS",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "615-988-2004"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Batesville, MS

Sources for this page

Verify at the official NPI Registry.