NPIMap

Organization Active NPI

Clinton Medical Center

  • VA Clinic/Center
  • Byram, MS
National Provider Identifier
1245770445
Registry record updated Mar 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
VA Clinic/CenterTaxonomy code 261QV0200X
License
901392 Issued in MS
Legal business name
CLINTON MEDICAL CENTER
Practice address
604 Lexington CV
Byram, MS 39272-3004
Phone
(601) 259-4471
NPI assigned
Mar 7, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2017

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

Authorized official

Name
Dewona Flowers
Title
Nurse Practitioner
Phone
(601) 259-4771

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
VA Clinic/Center 261QV0200X 901392 MS Primary

Addresses

Primary practice location

604 Lexington CV
Byram, MS 39272-3004

Mailing address

604 Lexington CV
Byram, MS 39272-3004

National Provider Directory

National Provider Directory
Tax ID family
Clinton Medical Center2 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.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1488844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488844800000",
    "number": "1245770445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 LEXINGTON CV",
            "city": "BYRAM",
            "state": "MS",
            "postal_code": "392723004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 LEXINGTON CV",
            "city": "BYRAM",
            "state": "MS",
            "postal_code": "392723004",
            "telephone_number": "601-259-4471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINTON MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-07",
        "last_updated": "2017-03-07",
        "status": "A",
        "authorized_official_last_name": "FLOWERS",
        "authorized_official_first_name": "DEWONA",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "601-259-4771"
    },
    "taxonomies": [
        {
            "code": "261QV0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, VA",
            "state": "MS",
            "license": "901392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Byram, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2017; 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.