NPIMap

Organization Active NPI

Wellness & Clinical Solutions LLC

Doing business as Avalon Medical Clinic

  • Family Medicine Physician
  • Iuka, MS
National Provider Identifier
1184485070
Registry record updated Jan 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
WELLNESS & CLINICAL SOLUTIONS LLC
Doing business as
Avalon Medical Clinic
Practice address
1413 W Quitman St
Iuka, MS 38852-1130
Phone
(662) 424-9550
NPI assigned
Jan 18, 2024
Last updated
Jan 18, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2024

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

Authorized official

Name
Mr. Timothy GriffinNPI 1740886985
Title
Owner
Phone
(662) 279-0599

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

1413 W Quitman St
Iuka, MS 38852-1130

Mailing address

1413 W Quitman St
Iuka, MS 38852-1130
Phone (662) 424-9550

Other names 1

  • Avalon Medical Clinic Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1705536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705536000000",
    "number": "1184485070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1413 W QUITMAN ST",
            "city": "IUKA",
            "state": "MS",
            "postal_code": "388521130",
            "telephone_number": "662-424-9550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1413 W QUITMAN ST",
            "city": "IUKA",
            "state": "MS",
            "postal_code": "388521130",
            "telephone_number": "662-424-9550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESS & CLINICAL SOLUTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-18",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A",
        "authorized_official_last_name": "GRIFFIN",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "662-279-0599",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avalon Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Iuka, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2024; 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.