Bounds Family Medical

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

BOUNDS FAMILY MEDICAL

Practice address

870 Main St Ste a
Fayette, MS 39069-5695

Phone

(601) 809-0882

Fax

(601) 809-0883

NPI assigned

Jan 15, 2020

Last updated

Jan 15, 2020By 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

Amber Henderson

Title

Office Manager

Phone

(601) 809-0882

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1194365338. Details of each certification follow.

• CCN A53845 Rural health clinic · Active · Details

Rural health clinic certification: CCN A53845

Legal name

BOUNDS FAMILY MEDICAL

Doing business as

BOUNDS FAMILY MEDICAL

Certification status

Active

Provider type (POS)

Rural health clinic

Participating since

Aug 5, 2025

Last certification

Aug 5, 2025

Ownership / control type

1A

Organization structure

CorporationProprietary

Enrollment address

821 Main Street
Fayette, MS 39069

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Bounds Family Medical

  • Family Medicine Physician
  • Fayette, MS
  • NPI 1831656354

  2163761131

  Same PAC ID

Tax ID family

Bounds Family Medical2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Bounds Family Medical

  • Family Medicine Physician
  • Fayette, MS
  • NPI 1831656354
  NPD tax ID

Locations

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Matthew Kevin Bounds, FNP-C

  • Family Nurse Practitioner
  • Fayette, MS
  • NPI 1295273670

  5% Or Greater Direct Ownership Interest, W-2 Managing Employee

  CMS ownership

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.

• Veronica R Hutchins-Clemons, NP

  • Gerontology Nurse Practitioner
  • Fayette, MS
  • NPI 1821622218
  NPD
• Veronica Mays Jackson

  • Medical-Surgical Registered Nurse
  • Fayette, MS
  • NPI 1851184295
  NPD (past)
• Shanti Pandey, M.D.

  • Legal Medicine
  • Fayette, MS
  • NPI 1538170683
  NPD (past)

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

{
    "created_epoch": "1579046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579046400000",
    "number": "1194365338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 91",
            "city": "FAYETTE",
            "state": "MS",
            "postal_code": "390690091",
            "telephone_number": "601-809-0882",
            "fax_number": "601-809-0883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "870 MAIN ST STE A",
            "city": "FAYETTE",
            "state": "MS",
            "postal_code": "390695695",
            "telephone_number": "601-809-0882",
            "fax_number": "601-809-0883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOUNDS FAMILY MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-15",
        "last_updated": "2020-01-15",
        "certification_date": "2020-01-15",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "AMBER",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "601-809-0882"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anazia Medical II, Inc.
• At Home Care, Inc.
• At Home Hospice Care, Inc.
• Alicia R Berry-Kaho, LPN
• Bounds Family Medical
• Matthew Kevin Bounds, FNP-C
• Hattori Almeshia Brice
• CC Reliable Care Services LLC
• Chambliss Counseling Services PLLC

• Rural Health Clinic/Center in Fayette, MS
• Providers in Fayette, MS by specialty
• Rural Health Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.