NPIMap

Organization Active NPI

Maxem Health Urgent Care McComb

Doing business as McComb Urgent Care

  • Urgent Care Clinic/Center
  • McComb, MS
National Provider Identifier
1235619479
Registry record updated Aug 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
MAXEM HEALTH URGENT CARE MCCOMB
Doing business as
McComb Urgent Care
Practice address
101 Edgewood Dr
McComb, MS 39648-2043
Phone
(228) 223-1927
Fax
(228) 382-9224
NPI assigned
Aug 16, 2018
Last updated
Aug 16, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2018

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

Authorized official

Name
Brianne Whitney
Title
President
Phone
(707) 319-5068

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

101 Edgewood Dr
McComb, MS 39648-2043

Mailing address

PO Box 1248
Ocean Springs, MS 39566-1248
Phone (707) 319-5068

Other names 1

  • McComb Urgent Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181231000649 MS Part B Supplier - Clinic/Group Practice 6305181959 Receives reassigned benefits from 29 practitioners
Practice locations: McComb, MS

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
25D2158695Maxem Health Urgent Care McComb101A Edgewood Dr, McComb, MS 39648Certificate of waiverDec 3, 2026

National Provider Directory

National Provider Directory

Locations

101 Edgewood Dr
McComb, MS 39648
Phone (601) 324-3244

101A Edgewood Dr
McComb, MS 39648

Practitioners & affiliated clinicians

Practitioners 29

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.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1534377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534377600000",
    "number": "1235619479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1248",
            "city": "OCEAN SPRINGS",
            "state": "MS",
            "postal_code": "395661248",
            "telephone_number": "707-319-5068",
            "fax_number": "228-382-9224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 EDGEWOOD DR",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396482043",
            "telephone_number": "228-223-1927",
            "fax_number": "228-382-9224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAXEM HEALTH URGENT CARE MCCOMB",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-16",
        "last_updated": "2018-08-16",
        "status": "A",
        "authorized_official_last_name": "WHITNEY",
        "authorized_official_first_name": "BRIANNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "707-319-5068"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "McComb Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in McComb, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2018; 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.