Mid-South Direct Primary Care

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

MID-SOUTH DIRECT PRIMARY CARE

Practice address

1229 Ms-42 Suite 270
Petal, MS 39465

Phone

(769) 223-9503

Fax

(601) 336-4925

NPI assigned

Apr 18, 2025

Last updated

Apr 18, 2025By the provider in NPPES

Organization subpart

Yes

Parent organization

HENDRY HEALTHCARE PLLCAs reported in NPPES

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

Authorized official

Name

Ashlee Hendry, DO

Title

D.O./Administrator

Phone

(769) 223-9503

Specialties & licenses 1

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

Mid-South Direct Primary Care

Locations

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

{
    "created_epoch": "1744934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744934400000",
    "number": "1346036977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1229 MS-42 SUITE 270",
            "city": "PETAL",
            "state": "MS",
            "postal_code": "39465",
            "telephone_number": "769-223-9503",
            "fax_number": "601-336-4925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1229 MS-42 SUITE 270",
            "city": "PETAL",
            "state": "MS",
            "postal_code": "39465",
            "telephone_number": "769-223-9503",
            "fax_number": "601-336-4925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-SOUTH DIRECT PRIMARY CARE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HENDRY HEALTHCARE PLLC",
        "enumeration_date": "2025-04-18",
        "last_updated": "2025-04-18",
        "certification_date": "2025-04-07",
        "status": "A",
        "authorized_official_last_name": "HENDRY",
        "authorized_official_first_name": "ASHLEE",
        "authorized_official_title_or_position": "D.O./ADMINISTRATOR",
        "authorized_official_telephone_number": "769-223-9503",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alicia Martin
• Barbara B Mauldin, D.M.D.
• Tabatha McKinney, PHARMD
• Tim McWilliams
• Adam Meyers, AGACNP, RNFA
• Patricia A. Miller, D.O.
• Raven Miller
• Alvaro Jorge Moreno, O.D.
• Alvaro Paul Moreno, OD
• Pedro Saul Moreno, A.T.C.

• Primary Care Clinic/Center in Petal, MS
• Providers in Petal, MS by specialty
• Primary Care Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2025; 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.