Crawford Mobile Health Clinic

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

License

R740067 Issued in MS

Legal business name

CRAWFORD MOBILE HEALTH CLINIC

Practice address

15865 Highway 14 West
Macon, MS 39341-0402

Phone

(662) 435-7800

NPI assigned

Mar 22, 2012

Last updated

Mar 22, 2012By the provider in NPPES

Organization subpart

Yes

Parent organization

CRAWFORD HEALTH CLINICAs reported in NPPES

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

Authorized official

Name

Felicia Deloris Edwards, NP

Title

Manaing Partner

Phone

(662) 435-7800

Specialties & licenses 2

Addresses

Other identifiers 1

Part of

Crawford Health Clinic LLC

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Crawford Health Clinic, LLC

  • Rural Health Clinic/Center
  • Macon, MS
  • NPI 1912193459
  NPPES parent name

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.

• Felicia Deloris Washington, FNP

  • Family Nurse Practitioner
  • Gainsville, GA
  • NPI 1316040264
  NPD (past)

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

{
    "created_epoch": "1332374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332374400000",
    "number": "1245506377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 95",
            "city": "CRAWFORD",
            "state": "MS",
            "postal_code": "397430095",
            "telephone_number": "662-435-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15865 HIGHWAY 14 WEST",
            "city": "MACON",
            "state": "MS",
            "postal_code": "393410402",
            "telephone_number": "662-435-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRAWFORD MOBILE HEALTH CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CRAWFORD HEALTH CLINIC",
        "enumeration_date": "2012-03-22",
        "last_updated": "2012-03-22",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "FELICIA",
        "authorized_official_middle_name": "DELORIS",
        "authorized_official_title_or_position": "MANAING PARTNER",
        "authorized_official_telephone_number": "662-435-7800",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MS",
            "license": "R740067",
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "MS",
            "license": "R740067",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1316040264",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yolanda M Bush, FNP
• Patricia L Campbell, CFNP
• Beverly W Clark, FNP-C
• Marlina Conner
• Crawford Health Clinic, LLC
• Katherine Dalstra
• Roxie Joy Dickson
• Shalena Dixon
• Jennifer Yuson Dozier, NP
• Alan L Ezell I, D.M.D.

• Rural Health Clinic/Center in Macon, MS
• Providers in Macon, 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 Mar 22, 2012; 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.