Premier Family and Urgent Care

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

PREMIER FAMILY AND URGENT CARE

Practice address

2394 McCullough Blvd
Belden, MS 38826-9579

Phone

(622) 053-0236

Fax

(844) 465-9102

NPI assigned

Feb 25, 2019

Organization subpart

No

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

Authorized official

Name

Jessica Hicks-Robertson, FNP

Title

Owner

Phone

(662) 840-4577

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1551052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598832000000",
    "number": "1104383389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2394 MCCULLOUGH BLVD",
            "city": "BELDEN",
            "state": "MS",
            "postal_code": "388269579",
            "telephone_number": "662-269-1774",
            "fax_number": "844-465-9102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2394 MCCULLOUGH BLVD",
            "city": "BELDEN",
            "state": "MS",
            "postal_code": "388269579",
            "telephone_number": "622-053-0236",
            "fax_number": "844-465-9102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER FAMILY AND URGENT CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-25",
        "last_updated": "2020-08-31",
        "certification_date": "2020-08-31",
        "status": "A",
        "authorized_official_last_name": "HICKS-ROBERTSON",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "662-840-4577",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03403770",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Belden, MS
• Providers in Belden, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2020; 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.