P&S Primary Care, PLLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

P&S PRIMARY CARE, PLLC

Practice address

900 Earl Frye Blvd Ste a
Amory, MS 38821-5507

Phone

(662) 256-9331

NPI assigned

Oct 8, 2019

Organization subpart

Yes

Parent organization

P & S CLINIC OB-GYNAs reported in NPPES

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

Authorized official

Name

Mr. Timothy Wayne Boden, CMPE

Title

Executive Director

Phone

(662) 256-9331

Specialties & licenses 2

Addresses

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

CLIA laboratory certificates

Part of

Kim Ennis MD

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.

• P & S Clinic OB-GYN PLLC

  • Obstetrics & Gynecology Physician
  • Amory, MS
  • NPI 1538215546
  NPPES parent name

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

{
    "created_epoch": "1570492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570492800000",
    "number": "1245872514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 EARL FRYE BLVD STE A",
            "city": "AMORY",
            "state": "MS",
            "postal_code": "388215507",
            "telephone_number": "662-256-9331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 EARL FRYE BLVD STE A",
            "city": "AMORY",
            "state": "MS",
            "postal_code": "388215507",
            "telephone_number": "662-256-9331"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Brandon Rd",
            "address_purpose": "LOCATION",
            "city": "Starkville",
            "state": "MS",
            "postal_code": "397592571",
            "country_code": "US",
            "telephone_number": "662-268-8161",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "P&S PRIMARY CARE, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "P & S CLINIC OB-GYN",
        "enumeration_date": "2019-10-08",
        "last_updated": "2019-10-08",
        "status": "A",
        "authorized_official_last_name": "BODEN",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "662-256-9331",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CMPE"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Terry William Odom, M.D.
• Ortho Express Holding Company, LLC
• Orthopaedic Institute of North Mississippi, LLC
• Stephen K Otey, MD
• P & S Clinic OB-GYN PLLC
• Adrienne Paige, M.D.
• Gerald L Parker, MD
• William Blake Parker, DPT
• Kristin Blair Patterson, FNP-C
• Peaceful Sleep

• Pediatrics Physician in Amory, MS
• Providers in Amory, MS by specialty
• Pediatrics Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.