Family Medical Clinic of Okolona

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

FAMILY MEDICAL CLINIC OF OKOLONA

Practice address

521 West Dr
Okolona, MS 38860-1625

Phone

(662) 447-1405

Fax

(662) 447-1408

NPI assigned

Oct 18, 2006

Last updated

Jan 18, 2024By 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

Ms. Sheila Brockman

Title

Ceo

Phone

(662) 456-3700

Specialties & licenses 1

Addresses

Tax ID family

Trace Regional Surgery2 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.

• Southern Health Corp. of Houston, Inc.

  dba Trace Regional Hospital

  • Clinic/Center
  • Houston, MS
  • NPI 1003096488
  NPD tax ID

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.

• Joy S Chapman, NP

  • Nurse Practitioner
  • Okolona, MS
  • NPI 1427064344
  NPD (past)

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705536000000",
    "number": "1336220029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 WEST DR",
            "city": "OKOLONA",
            "state": "MS",
            "postal_code": "388601625",
            "telephone_number": "662-447-1405",
            "fax_number": "662-447-1408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 WEST DR",
            "city": "OKOLONA",
            "state": "MS",
            "postal_code": "388601625",
            "telephone_number": "662-447-1405",
            "fax_number": "662-447-1408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY MEDICAL CLINIC OF OKOLONA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A",
        "authorized_official_last_name": "BROCKMAN",
        "authorized_official_first_name": "SHEILA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "662-456-3700",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephenie Brady
• Michael Bullock
• Sarah Carollo
• Joy S Chapman, NP
• Chickasaw FMC
• Shatessie Marie Ford, CRT
• Harley's Home Care
• Heavenly Angels Community Living, Inc.
• Whitley Breanna Hill, EN
• Hodges Adult Day Care Service Inc

• Health Service Clinic/Center in Okolona, MS
• Providers in Okolona, MS by specialty
• Health Service Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2024; 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.