Jrco, LLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

15421 Issued in MS

Legal business name

JRCO, LLC

Doing business as

Caledonia Medical Care

Practice address

9692 Wolfe Rd
Caledonia, MS 39740

Phone

(662) 356-0320

Fax

(662) 356-0322

NPI assigned

Jul 31, 2013

Last updated

Jul 31, 2013By 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

Alvin Ray Beezley Jr., D.O.NPI 1922056159

Title

Provider

Phone

(662) 356-0320

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• CALEDONIA MEDICAL CARE Doing business as

Practitioners 1

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.

• Alvin Ray Beezley Jr., D. O.

  • Internal Medicine Physician
  • Caledonia, MS
  • NPI 1922056159
  NPD (past) Authorized official

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

{
    "created_epoch": "1375228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375228800000",
    "number": "1184056285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9692 WOLFE RD",
            "city": "CALEDONIA",
            "state": "MS",
            "postal_code": "397409223",
            "telephone_number": "662-356-0320",
            "fax_number": "662-356-0322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9692 WOLFE RD",
            "city": "CALEDONIA",
            "state": "MS",
            "postal_code": "39740",
            "telephone_number": "662-356-0320",
            "fax_number": "662-356-0322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JRCO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-31",
        "last_updated": "2013-07-31",
        "status": "A",
        "authorized_official_last_name": "BEEZLEY",
        "authorized_official_first_name": "ALVIN",
        "authorized_official_middle_name": "RAY",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "662-356-0320",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MS",
            "license": "15421",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07757360",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "512I110141",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CALEDONIA MEDICAL CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kelsey Melane Dement
• Fig Leaf, LLC (Caledonia Community Clinic)
• Misty S Glasgow, OTR
• Golden Triangle Family Eye Care, PLLC (Caledonia Vision Center)
• Lisa Jordan Hudson, FNP-C
• Maegan Mattison, CLPN
• Joachim Yves McKinney, PHARM D
• Pioneer Health Services of Monroe County, Inc (Pioneer Family Medical of Caledonia)
• Nicholas Thomas Richardson, O.D.
• Leslie Herndon Singley

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2013; 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.