NPIMap

Organization Active NPI

Tyler Holmes Walk-in Clinic

  • Clinic/Center
  • Winona, MS
National Provider Identifier
1336420587
Registry record updated Sep 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
R659983 Issued in MS
Legal business name
TYLER HOLMES WALK-IN CLINIC
Practice address
409 Tyler Holmes Dr
Winona, MS 38967-1521
Phone
(662) 283-5295
Fax
(662) 283-5296
NPI assigned
Sep 1, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2011

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

Authorized official

Name
Ms. Terri H McCrary
Title
Office Manager
Phone
(662) 283-6121

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X R659983 MS Primary

Addresses

Primary practice location

409 Tyler Holmes Dr
Winona, MS 38967-1521

Mailing address

409 Tyler Holmes Dr
Winona, MS 38967-1521
Phone (662) 283-5295

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040126000826 MS Part B Supplier - Clinic/Group Practice 0345142618 Receives reassigned benefits from 14 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Winona, MS; North Carrollton, MS; Kilmichael, MS

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Tyler Holmes Memorial Hospital7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

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": "1314835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314835200000",
    "number": "1336420587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 TYLER HOLMES DR",
            "city": "WINONA",
            "state": "MS",
            "postal_code": "389671521",
            "telephone_number": "662-283-5295",
            "fax_number": "662-283-5296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 TYLER HOLMES DR",
            "city": "WINONA",
            "state": "MS",
            "postal_code": "389671521",
            "telephone_number": "662-283-5295",
            "fax_number": "662-283-5296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TYLER HOLMES WALK-IN CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-01",
        "last_updated": "2011-09-01",
        "status": "A",
        "authorized_official_last_name": "MCCRARY",
        "authorized_official_first_name": "TERRI",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "662-283-6121",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MS",
            "license": "R659983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winona, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.