GSV Care Medical Clinic

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

License

R850148 Issued in MS

Legal business name

GSV CARE MEDICAL CLINIC

Practice address

400 Third Avenue
Houlka, MS 38850

Phone

(662) 568-2013

Fax

(662) 568-2023

NPI assigned

Mar 15, 2013

Last updated

Mar 11, 2016By 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

Mrs. Manda Griffin, DNPNPI 1386781151

Title

Owner

Phone

(662) 983-0422

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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.

• Manda Sue Griffin, DNP

  • Family Nurse Practitioner
  • Houlka, MS
  • NPI 1386781151
  Authorized official Same address or phone

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

{
    "created_epoch": "1363305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457654400000",
    "number": "1275874281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 THIRD AVENUE",
            "city": "HOULKA",
            "state": "MS",
            "postal_code": "38850",
            "telephone_number": "662-568-2013",
            "fax_number": "662-568-2023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 THIRD AVENUE",
            "city": "HOULKA",
            "state": "MS",
            "postal_code": "38850",
            "telephone_number": "662-568-2013",
            "fax_number": "662-568-2023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GSV CARE MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-15",
        "last_updated": "2016-03-11",
        "status": "A",
        "authorized_official_last_name": "GRIFFIN",
        "authorized_official_first_name": "MANDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "662-983-0422",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "DNP"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "MS",
            "license": "R850148",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04506555",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Access Family Health Services, Inc. (ACCESS Family Health - Houlka Clinic)
• Rhonda Carol Baker
• Manda Sue Griffin, DNP
• Megan Celeste Hardin, FNP-C
• Candace Miles, COTA/L
• Jennifer Ray, LMHC
• Rachel Warren Rish, CFNP
• Dorthia S Walters, CFNP

• Rural Health Clinic/Center in Houlka, MS
• Providers in Houlka, 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 11, 2016; 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.