Family Health Clinic of Grenada

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R875035 Issued in MS

Legal business name

FAMILY HEALTH CLINIC OF GRENADA

Practice address

1117 Sunset Dr Ste 104
Grenada, MS 38901-4080

Phone

(662) 226-0110

Fax

(662) 226-3700

NPI assigned

Nov 13, 2007

Last updated

Dec 1, 2016By 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

Mr. Henry Brister

Title

Owner

Phone

(662) 226-0110

Specialties & licenses 2

Addresses

Other identifiers 1

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

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/16954/brand/1/csg/1/fhir/r4

Practitioners 5

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.

• Ashley Nicole Woods, FNP

  • Family Nurse Practitioner
  • Grenada, MS
  • NPI 1134903321
  Medicare reassignment Care Compare group NPD
• Jennifer Lee Goss, FNP

  • Family Nurse Practitioner
  • Grenada, MS
  • NPI 1548608128
  Medicare reassignment Care Compare group
• Rebecca J Franklin, FNP-C

  • Family Nurse Practitioner
  • Grenada, MS
  • NPI 1902369457
  Medicare reassignment NPD
• Alison Campbell, FNP-C

  • Family Nurse Practitioner
  • Grenada, MS
  • NPI 1205441375
  NPD
• Joseph Frank Roberts, M.D.

  • Internal Medicine Physician
  • Grenada, MS
  • NPI 1023129608
  NPD (past)

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

{
    "created_epoch": "1194912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480550400000",
    "number": "1144400607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1117 SUNSET DR STE 104",
            "city": "GRENADA",
            "state": "MS",
            "postal_code": "389014080",
            "telephone_number": "662-226-0110",
            "fax_number": "662-226-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1117 SUNSET DR STE 104",
            "city": "GRENADA",
            "state": "MS",
            "postal_code": "389014080",
            "telephone_number": "662-226-0110",
            "fax_number": "662-226-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY HEALTH CLINIC OF GRENADA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-13",
        "last_updated": "2016-12-01",
        "status": "A",
        "authorized_official_last_name": "BRISTER",
        "authorized_official_first_name": "HENRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "662-226-0110",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R875035",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R742805",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01476010",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Catiecha L Eskridge
• Evolution Clinical Counseling and Services
• Family Cancer Center, PLLC
• Family Health Care Clinic, Inc
• Family Health Care Clinic, Inc.
• Tabatha Fant, FNP
• Emily A Fite, FNP
• Laura Hill Flippin, MSN, FNP-C
• Amy Floyd, FNP
• Mary Anne Frank-Tarsi, M.D.

• Family Nurse Practitioner in Grenada, MS
• Providers in Grenada, 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 Dec 1, 2016; 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.