NPIMap

Organization Active NPI

G a Carmichael Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Yazoo City, MS
National Provider Identifier
1184989196
Registry record updated Jul 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
G A CARMICHAEL FAMILY HEALTH CENTER
Practice address
622 E Fourth St
Yazoo City, MS 39194-3715
Phone
(601) 859-5213
Fax
(601) 859-8771
NPI assigned
Jul 6, 2012
Last updated
Jul 6, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2012

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

Authorized official

Name
Phyllis G Cotten
Title
Finance Director
Phone
(601) 859-5213

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

622 E Fourth St
Yazoo City, MS 39194-3715

Mailing address

PO Box 588
Canton, MS 39046-0588
Phone (601) 859-5213

Other identifiers 1

IdentifierTypeStateIssuer
APPLIED FORMedicaidMS

Other names 1

  • Webster Elementary School Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1184989196. Details of each certification follow.

  • CCN 251916 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 251916

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
WEBSTER ELEMENTARY SCHOOL
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 1, 2003
Last certification
Jul 1, 2003
Ownership / control type
For profit – corporation
Facility address
622 East 4TH Street
Yazoo City, MS 39194
Related CCNs
251806

National Provider Directory

National Provider Directory
Tax ID family
M Y L Family Health Ctr26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

Organizations that report the same tax identification number in the National Provider Directory.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1341532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1341532800000",
    "number": "1184989196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 588",
            "city": "CANTON",
            "state": "MS",
            "postal_code": "390460588",
            "telephone_number": "601-859-5213",
            "fax_number": "601-859-8771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 E FOURTH ST",
            "city": "YAZOO CITY",
            "state": "MS",
            "postal_code": "391943715",
            "telephone_number": "601-859-5213",
            "fax_number": "601-859-8771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "G A CARMICHAEL FAMILY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-06",
        "last_updated": "2012-07-06",
        "status": "A",
        "authorized_official_last_name": "COTTEN",
        "authorized_official_first_name": "PHYLLIS",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "FINANCE DIRECTOR",
        "authorized_official_telephone_number": "601-859-5213"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "APPLIED FOR",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Webster Elementary School",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Yazoo City, MS

Sources for this page

Verify at the official NPI Registry.