Organization Active NPI

Corinth Family Medical Center

  • Family Nurse Practitioner
  • Corinth, MS
National Provider Identifier
1326239278
Registry record updated Aug 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R860333 Issued in MS
Legal business name
CORINTH FAMILY MEDICAL CENTER
Practice address
1921 Droke Rd
Corinth, MS 38834-6604
Phone
(662) 415-4762
NPI assigned
Aug 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2007

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

Authorized official

Name
Mr. Jim T Wigginton, NPNPI 1538152756
Title
NP
Phone
(662) 415-4762

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X R860333 MS Primary

Addresses

Primary practice location

1921 Droke Rd
Corinth, MS 38834-6604

Mailing address

1921 Droke Rd
Corinth, MS 38834-6604
Phone (662) 415-4762

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080401000328 MS Part B Supplier - Clinic/Group Practice 5890871883 Receives reassigned benefits from 1 practitioner
Practice locations: Corinth, 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
25D1078297Corinth Family Medical Center1921 Droke Road, Corinth, MS 38834Certificate of waiverOct 26, 2026

National Provider Directory

National Provider Directory

Locations

1921 Droke Rd
Corinth, MS 38834
Phone (662) 286-3520

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": "1186358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186358400000",
    "number": "1326239278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1921 DROKE RD",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388346604",
            "telephone_number": "662-415-4762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1921 DROKE RD",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388346604",
            "telephone_number": "662-415-4762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORINTH FAMILY MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-06",
        "last_updated": "2007-08-06",
        "status": "A",
        "authorized_official_last_name": "WIGGINTON",
        "authorized_official_first_name": "JIM",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "NP",
        "authorized_official_telephone_number": "662-415-4762",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R860333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corinth, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2007; 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.