Kelly S Segars MD PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

10016 Issued in MS

Legal business name

KELLY S SEGARS MD PC

Doing business as

The Segars Clinic

Practice address

1507 W Quitman St
Iuka, MS 38852-1132

Phone

(662) 423-1000

Fax

(662) 423-1316

NPI assigned

May 18, 2006

Last updated

Sep 10, 2012By 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

Mona A McWilliams

Title

Billing Manager

Phone

(662) 423-1000

Specialties & licenses 2

Addresses

Other identifiers 23

Other names 1

• THE SEGARS CLINIC Doing business as

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 9

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.

• Sara Cooley, NP-C

  • Family Nurse Practitioner
  • Iuka, MS
  • NPI 1164891438
  Medicare reassignment Care Compare group NPD
• Jessica Kate Glover

  • Family Nurse Practitioner
  • Huntsville, AL
  • NPI 1427565076

  MS

  Medicare reassignment Care Compare group NPD
• Elizabeth K Thompson, APRN

  • Family Nurse Practitioner
  • Memphis, TN
  • NPI 1194956755

  MS

  Medicare reassignment Care Compare group NPD
• Margaret M Glynn, M.D.

  • Family Medicine Physician
  • Iuka, MS
  • NPI 1750386488
  Medicare reassignment Care Compare group
• Kelly S Segars Jr., M.D.

  • Family Medicine Physician
  • Iuka, MS
  • NPI 1609871607
  Medicare reassignment Care Compare group
• Braxton Kye Meeks, FNP

  • Family Nurse Practitioner
  • Iuka, MS
  • NPI 1922822501
  Medicare reassignment
• Teresa M South, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Iuka, MS
  • NPI 1649429481
  Medicare reassignment
• Elizabeth Senn Dawson, CRNP

  • Family Nurse Practitioner
  • Iuka, MS
  • NPI 1013189927
  NPD (past)
• Ashli Richardson Vandiver

  • Family Nurse Practitioner
  • Iuka, MS
  • NPI 1619891306
  NPD (past)

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347235200000",
    "number": "1073566550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1507 W QUITMAN ST",
            "city": "IUKA",
            "state": "MS",
            "postal_code": "388521132",
            "telephone_number": "662-423-1000",
            "fax_number": "662-423-1316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1507 W QUITMAN ST",
            "city": "IUKA",
            "state": "MS",
            "postal_code": "388521132",
            "telephone_number": "662-423-1000",
            "fax_number": "662-423-1316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLY S SEGARS MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2012-09-10",
        "status": "A",
        "authorized_official_last_name": "MCWILLIAMS",
        "authorized_official_first_name": "MONA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "BILLING  MANAGER",
        "authorized_official_telephone_number": "662-423-1000"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MS",
            "license": "12314",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MS",
            "license": "10016",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00017574",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1750386488",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "420866905",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "011800024",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080117421",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1649429481",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "487623030",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "587286250",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00013060",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00835093",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05989006",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1750387890",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "428559600",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "418807663",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "500001207",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "587922966",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00123795",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1609871607",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "5121500341",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03171239",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04426008",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1124298849",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "5121500528",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "THE SEGARS CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Hope Ross Johnson
• Michelle Johnson
• Samuel Casey Johnson, LCSW
• Barbara Gayle Jones, RPH.
• Keith Vuncannon & Brad Stephenson PTRS Caring Hands Rehab
• Ben Earl Kitchens, MD
• Mohamed Z Knefati, M.D.
• Amanda Lambert, MS, LPC
• Cynthia Lyn Lambert
• Macy Renee Lambert, PCSS

• Specialist in Iuka, MS
• Providers in Iuka, MS by specialty
• Specialist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2012; 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.